Provider Demographics
NPI:1265481675
Name:PIEDMONT ANESTHESIA ASSOCIATES, PA
Entity Type:Organization
Organization Name:PIEDMONT ANESTHESIA ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:GUIDEDDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-789-6116
Mailing Address - Street 1:PO BOX 992
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:NC
Mailing Address - Zip Code:27030-0992
Mailing Address - Country:US
Mailing Address - Phone:336-789-6116
Mailing Address - Fax:336-789-6116
Practice Address - Street 1:830 ROCKFORD ST
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:NC
Practice Address - Zip Code:27030-5322
Practice Address - Country:US
Practice Address - Phone:336-789-6116
Practice Address - Fax:336-789-6116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7902446Medicaid
0669Medicare ID - Type Unspecified