Provider Demographics
NPI:1366486508
Name:MID-ATLANTIC ANESTHESIA ASSOCIATES PA
Entity Type:Organization
Organization Name:MID-ATLANTIC ANESTHESIA ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-757-3836
Mailing Address - Street 1:PO BOX 8505
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-0505
Mailing Address - Country:US
Mailing Address - Phone:856-755-1616
Mailing Address - Fax:856-755-0098
Practice Address - Street 1:1600 HADDON AVE
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-3101
Practice Address - Country:US
Practice Address - Phone:856-757-3836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP2040780OtherOXFORD
NJ009928OtherAETNA
NJ0082512000OtherAMERIHEALTH
NJA33261OtherAMERIHEALTH ADMINISTRATOR
NJ1005400OtherHORIZON NJ HEALTH
NJ13896400OtherUS DEPT OF LABOR
NJ2769204Medicaid
NJCC9632OtherRAILROAD MEDICARE
NJ1005400OtherHORIZON NJ HEALTH
NJP2040780OtherOXFORD
NJ133261Medicare ID - Type Unspecified