Provider Demographics
NPI:1417134263
Name:MARKED ANESTHESIA CARE INC
Entity Type:Organization
Organization Name:MARKED ANESTHESIA CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARCOS
Authorized Official - Middle Name:S
Authorized Official - Last Name:FALTAMO
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:301-317-0020
Mailing Address - Street 1:3640 LYONS CREEK ROAD
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:MD
Mailing Address - Zip Code:20754
Mailing Address - Country:US
Mailing Address - Phone:301-317-0020
Mailing Address - Fax:301-317-0028
Practice Address - Street 1:7700 OLD BRANCH AVE
Practice Address - Street 2:#A102
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20785
Practice Address - Country:US
Practice Address - Phone:301-317-0020
Practice Address - Fax:301-317-0028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty