Provider Demographics
NPI:1366489643
Name:PRICE, DAVID R (CRNA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:R
Last Name:PRICE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1034 GROVE ST
Mailing Address - Street 2:ANESTHESIA CONSULTANTS
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-2945
Mailing Address - Country:US
Mailing Address - Phone:814-333-5728
Mailing Address - Fax:814-333-5726
Practice Address - Street 1:1034 GROVE ST
Practice Address - Street 2:ANESTHESIA CONSULTANTS
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-2945
Practice Address - Country:US
Practice Address - Phone:814-333-5728
Practice Address - Fax:814-333-5726
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN519542L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1012851690003Medicaid
PA081603GC9Medicare UPIN