Basic Information
| Provider Information | |||||||||
| NPI: | 1457871238 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DANIEL MATTHEW HEMRICK, INC | ||||||||
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| OtherOrganizationName: | AXIS ANESTHESIA SOLUTIONS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2912 VIRGINIA RD | ||||||||
| Address2: | |||||||||
| City: | MOUNTAIN BRK | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352231254 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 7300 HALCYON SUMMIT DR | ||||||||
| Address2: | |||||||||
| City: | MONTGOMERY | ||||||||
| State: | AL | ||||||||
| PostalCode: | 361173699 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059779876 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2017 | ||||||||
| LastUpdateDate: | 11/09/2017 | ||||||||
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| AuthorizedOfficialLastName: | HEMRICK | ||||||||
| AuthorizedOfficialFirstName: | DANIEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2052460183 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 1-096706 | AL | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.