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NPI Code Detail

MEDICARE: WANDA T TOBIAS CRNA

MEDICARE: WANDA T TOBIAS CRNA
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
1367500000XCertified Registered Nurse Anesthetist0024177506VA
2367500000XCertified Registered Nurse Anesthetist17827SC

General Provider Information

NPI Number : 1144205469
Entity Type Code : Individual
Provider Name (Legal Business Name) : WANDA T TOBIAS CRNA
Provider Business Mailing Address
First Line : 10628 PARK RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-8407
Country : US
Telephone Number : 301-741-6992
Fax Number :
Provider Business Practice Location Address
First Line : 10628 PARK RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-8407
Country : US
Telephone Number : 301-741-6992
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2005
Last Update Date : 01/17/2024

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1114929924 — DR. KEVIN SCOTT SMITH M.D.
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