Provider Demographics
NPI:1518617364
Name:CLEARWAY ANESTHESIA SERVICES SE LLC
Entity Type:Organization
Organization Name:CLEARWAY ANESTHESIA SERVICES SE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAMEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FREAS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:855-527-7246
Mailing Address - Street 1:201 DEFENSE HWY STE 205
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7096
Mailing Address - Country:US
Mailing Address - Phone:855-527-7246
Mailing Address - Fax:866-229-5063
Practice Address - Street 1:4901 GRANDE DR STE B
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-5936
Practice Address - Country:US
Practice Address - Phone:855-527-7246
Practice Address - Fax:833-810-1165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty