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NPI Code Detail

MEDICARE: ANESTHESIA ASSOCIATES OF NORTHERN INDIANA, PC

MEDICARE: ANESTHESIA ASSOCIATES OF NORTHERN INDIANA, PC
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 : 1962661876
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANESTHESIA ASSOCIATES OF NORTHERN INDIANA, PC
Provider Business Mailing Address
First Line : 2914 S REPUBLIC BLVD
Second Line :
City : TOLEDO
State : OH
Zip : 43615-1912
Country : US
Telephone Number : 419-531-8808
Fax Number : 419-531-8877
Provider Business Practice Location Address
First Line : 416 E MAUMEE ST
Second Line :
City : ANGOLA
State : IN
Zip : 46703-2015
Country : US
Telephone Number : 419-531-8808
Fax Number : 419-531-8877
Authorized Official
Title or Position : DIRECTOR OF BILLING
Name : KARYN KOVACH
Credential :
Telephone Number : 419-531-8808
Provider Enumeration Date : 06/05/2008
Last Update Date : 06/05/2008

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Directions to “ANESTHESIA ASSOCIATES OF NORTHERN INDIANA, PC ” Practice Location

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