Basic Information
| Provider Information | |||||||||
| NPI: | 1295006054 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MCELFRESH ANESTHESIA LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1018 HART RD | ||||||||
| Address2: | |||||||||
| City: | TOWSON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212861629 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3013170020 | ||||||||
| FaxNumber: | 3013170028 | ||||||||
| Practice Location | |||||||||
| Address1: | 1018 HART RD | ||||||||
| Address2: | |||||||||
| City: | TOWSON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212861629 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3013170020 | ||||||||
| FaxNumber: | 3013170028 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2012 | ||||||||
| LastUpdateDate: | 01/25/2012 | ||||||||
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| AuthorizedOfficialLastName: | MCELFRESH | ||||||||
| AuthorizedOfficialFirstName: | DUNCAN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3013170020 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | CRNA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | R083667 | MD | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.