Provider Demographics
NPI:1205027414
Name:CHVALA & ASSOCIATES, PC
Entity Type:Organization
Organization Name:CHVALA & ASSOCIATES, PC
Other - Org Name:SANDMAN ANESTHESIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:CHVALA
Authorized Official - Suffix:JR
Authorized Official - Credentials:CRNA
Authorized Official - Phone:770-573-4640
Mailing Address - Street 1:PO BOX 669084
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-0102
Mailing Address - Country:US
Mailing Address - Phone:770-578-4640
Mailing Address - Fax:770-977-7327
Practice Address - Street 1:2328 MILSTEAD CIR NE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-5769
Practice Address - Country:US
Practice Address - Phone:770-578-4640
Practice Address - Fax:770-977-7327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN095429367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty