Provider Demographics
NPI:1093269060
Name:OUTER BANKS ANESTHESIA & PERIOPERATIVE CARE SPECIALISTS PLLC
Entity Type:Organization
Organization Name:OUTER BANKS ANESTHESIA & PERIOPERATIVE CARE SPECIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:EMIL
Authorized Official - Last Name:PELLINI
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:757-635-8998
Mailing Address - Street 1:344 TULLS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MOYOCK
Mailing Address - State:NC
Mailing Address - Zip Code:27958-9368
Mailing Address - Country:US
Mailing Address - Phone:757-635-8998
Mailing Address - Fax:
Practice Address - Street 1:324 MONTICELLO AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-2834
Practice Address - Country:US
Practice Address - Phone:757-635-8998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-08
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0595207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty