Provider Demographics
NPI:1508846197
Name:ANESTHESIOLOGY CONSULTANTS OF COLUMBIA, PA
Entity Type:Organization
Organization Name:ANESTHESIOLOGY CONSULTANTS OF COLUMBIA, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:G.
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:HALADAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-434-2797
Mailing Address - Street 1:PO BOX 60314
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0314
Mailing Address - Country:US
Mailing Address - Phone:803-765-1838
Mailing Address - Fax:803-765-1732
Practice Address - Street 1:5 RICHLAND MEDICAL PARK
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-8000
Practice Address - Country:US
Practice Address - Phone:803-434-2797
Practice Address - Fax:803-434-7038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-19
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP0177Medicaid
SCGP0177Medicaid