Provider Demographics
NPI:1033161286
Name:AMERICAN ANESTHESIOLOGY OF MARYLAND, P.C.
Entity Type:Organization
Organization Name:AMERICAN ANESTHESIOLOGY OF MARYLAND, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-296-4616
Mailing Address - Street 1:1122 KENILWORTH DR STE 317
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2146
Mailing Address - Country:US
Mailing Address - Phone:410-296-4616
Mailing Address - Fax:410-337-5068
Practice Address - Street 1:6701 N CHARLES ST
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204
Practice Address - Country:US
Practice Address - Phone:410-296-4616
Practice Address - Fax:410-337-5068
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A.A. GROUP, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-16
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD207L00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD638105700Medicaid
MDH506Medicare PIN
MD638105700Medicaid
MDNNO4Medicare PIN
MDNNO4Medicare PIN