MEDICARE: MOSAIC ANESTHESIA & PERIOPERATIVE SERVICES, PA

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
1	207L00000X	Anesthesiology Physician

Other Identifiers

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

General Provider Information

NPI Number	:	1962459115
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOSAIC ANESTHESIA & PERIOPERATIVE SERVICES, PA

Provider Business Mailing Address
First Line	:	2719 NEUSE BLVD
Second Line	:	B & C
City	:	NEW BERN
State	:	NC
Zip	:	28562-2840
Country	:	US
Telephone Number	:	252-633-6117
Fax Number	:	252-633-2644

Provider Business Practice Location Address
First Line	:	2719 NEUSE BLVD
Second Line	:	B & C
City	:	NEW BERN
State	:	NC
Zip	:	28562-2840
Country	:	US
Telephone Number	:	252-633-6117
Fax Number	:	252-633-2644

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	AMY A BERGMAN
Credential	:
Telephone Number	:	252-633-6117

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	06/02/2014

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