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NPI Code Detail

MEDICARE: ANESTHESIA WORKS LLC

MEDICARE: ANESTHESIA WORKS LLC
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 : 1144557232
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANESTHESIA WORKS LLC
Provider Business Mailing Address
First Line : 148 WELCHMAN AVE
Second Line :
City : GOOSE CREEK
State : SC
Zip : 29445-7152
Country : US
Telephone Number : 843-327-6616
Fax Number :
Provider Business Practice Location Address
First Line : 1735 TAYLOR ST
Second Line :
City : COLUMBIA
State : SC
Zip : 29201-3452
Country : US
Telephone Number : 803-254-3452
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JOHN WALTHALL
Credential : CRNA
Telephone Number : 843-327-6616
Provider Enumeration Date : 11/10/2009
Last Update Date : 10/18/2010

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Directions to “ANESTHESIA WORKS LLC ” Practice Location

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