Provider Demographics
NPI:1043480031
Name:ANESTHESIA ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:ANESTHESIA ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:GUST
Authorized Official - Last Name:KOSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:906-265-4019
Mailing Address - Street 1:PO BOX 370
Mailing Address - Street 2:
Mailing Address - City:IRON MOUNTAIN
Mailing Address - State:MI
Mailing Address - Zip Code:49801-0370
Mailing Address - Country:US
Mailing Address - Phone:906-265-4019
Mailing Address - Fax:
Practice Address - Street 1:1301 CARPENTER AVE
Practice Address - Street 2:
Practice Address - City:IRON MOUNTAIN
Practice Address - State:MI
Practice Address - Zip Code:49801-4725
Practice Address - Country:US
Practice Address - Phone:906-774-1404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101008053207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI050B210034OtherBCBS
MI5221022Medicare UPIN