Provider Demographics
NPI:1407229354
Name:PRECISION ANESTHESIA PLLC
Entity Type:Organization
Organization Name:PRECISION ANESTHESIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:ATIF
Authorized Official - Middle Name:
Authorized Official - Last Name:BAWAHAB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-574-7109
Mailing Address - Street 1:4400 S SAGINAW ST
Mailing Address - Street 2:SUITE 1222
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-2645
Mailing Address - Country:US
Mailing Address - Phone:810-732-8336
Mailing Address - Fax:810-239-4346
Practice Address - Street 1:4400 S SAGINAW ST
Practice Address - Street 2:SUITE 1222
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-2645
Practice Address - Country:US
Practice Address - Phone:810-732-8336
Practice Address - Fax:810-239-4346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-31
Last Update Date:2015-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301098087207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty