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NPI Code Detail

MEDICARE: ADVANTAGE ANESTHESIA OF MARYLAND LLC

MEDICARE: ADVANTAGE ANESTHESIA OF MARYLAND 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

General Provider Information

NPI Number : 1952784621
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANTAGE ANESTHESIA OF MARYLAND LLC
Provider Business Mailing Address
First Line : 12240 INDIAN CREEK CT
Second Line : SUITE 130
City : BELTSVILLE
State : MD
Zip : 20705-1242
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12240 INDIAN CREEK CT
Second Line : SUITE 130
City : BELTSVILLE
State : MD
Zip : 20705-1242
Country : US
Telephone Number : 240-560-5089
Fax Number :
Authorized Official
Title or Position : CHIEF MEDICAL OFFICER
Name : DR. PETER GLASS
Credential : M.D.
Telephone Number : 240-560-5089
Provider Enumeration Date : 06/30/2015
Last Update Date : 06/28/2017

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Directions to “ADVANTAGE ANESTHESIA OF MARYLAND LLC ” Practice Location

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