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NPI Code Detail

MEDICARE: NORTHWEST ANESTHESIA LTD

MEDICARE: NORTHWEST ANESTHESIA LTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114917374
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHWEST ANESTHESIA LTD
Provider Business Mailing Address
First Line : 12303 DE PAUL DR
Second Line :
City : BRIDGETON
State : MO
Zip : 63044-2512
Country : US
Telephone Number : 314-344-7049
Fax Number : 314-344-7073
Provider Business Practice Location Address
First Line : 12303 DE PAUL DR
Second Line :
City : BRIDGETON
State : MO
Zip : 63044-2512
Country : US
Telephone Number : 314-344-7049
Fax Number : 314-344-7073
Authorized Official
Title or Position : PRESIDENT
Name : MR. ALAN R SCHNEIDER
Credential : MD
Telephone Number : 314-344-7049
Provider Enumeration Date : 10/27/2005
Last Update Date : 06/25/2008

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Practice Location Address:
12303 DE PAUL DR
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63044-2512
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Practice Fax:
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1659361715 — MR. ALAN R SCHNEIDER MD
Practice Location Address:
12303 DE PAUL DR
BRIDGETON, MO
63044-2512
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Practice Fax: 314-344-7073
1588654651 — MR. MARCELLUS R LAWRENCE MD
Practice Location Address:
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BRIDGETON, MO
63044-2512
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Practice Fax: 314-344-7073
1699766709 — MS. VIJAYALAKSHMI VALLURUPALLI MD
Practice Location Address:
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63044-2512
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Practice Fax: 314-344-7073

Directions to “NORTHWEST ANESTHESIA LTD ” Practice Location

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