Provider Demographics
NPI:1083652150
Name:MCAMIS ANESTHESIA CONSULTANTS
Entity Type:Organization
Organization Name:MCAMIS ANESTHESIA CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCAMIS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:423-624-8868
Mailing Address - Street 1:76 S CREST RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-4005
Mailing Address - Country:US
Mailing Address - Phone:423-624-2268
Mailing Address - Fax:
Practice Address - Street 1:1111 PROFESSIONAL BLVD
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-2588
Practice Address - Country:US
Practice Address - Phone:706-226-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP 6334Medicare ID - Type UnspecifiedGROUP MEDICARE ID#