Provider Demographics
NPI:1043434855
Name:REGIONAL ANESTHESIA ASSOCIATES, LLC
Entity Type:Organization
Organization Name:REGIONAL ANESTHESIA ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO DIRECTOR OF ANESTHESIA SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:NILSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:301-602-8576
Mailing Address - Street 1:28665 EARTHLITE RD
Mailing Address - Street 2:
Mailing Address - City:WYE MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21679-2024
Mailing Address - Country:US
Mailing Address - Phone:301-602-8576
Mailing Address - Fax:410-827-7076
Practice Address - Street 1:8905 FAIRVIEW RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4150
Practice Address - Country:US
Practice Address - Phone:301-588-8300
Practice Address - Fax:301-588-9256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0058012207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty