Provider Demographics
NPI:1508810953
Name:ANESTHESIA PERIOPERATIVE SERVICES, LLC
Entity Type:Organization
Organization Name:ANESTHESIA PERIOPERATIVE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:MULAIKAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-825-3131
Mailing Address - Street 1:PO BOX 303
Mailing Address - Street 2:
Mailing Address - City:STEVENSON
Mailing Address - State:MD
Mailing Address - Zip Code:21153-0303
Mailing Address - Country:US
Mailing Address - Phone:410-819-0710
Mailing Address - Fax:410-819-0712
Practice Address - Street 1:110 WEST RD
Practice Address - Street 2:SUITE 229
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2316
Practice Address - Country:US
Practice Address - Phone:410-825-3131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0021774207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDDA3696OtherRR MEDICARE
MD20620200000Medicaid
MD364MOtherMEDICARE GROUP