Provider Demographics
NPI:1548200975
Name:OUTPATIENT ANESTHESIA SERVICES PC
Entity Type:Organization
Organization Name:OUTPATIENT ANESTHESIA SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-356-0300
Mailing Address - Street 1:PO BOX 32550
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21282-2550
Mailing Address - Country:US
Mailing Address - Phone:410-356-0300
Mailing Address - Fax:410-356-0309
Practice Address - Street 1:23 CROSSROADS DR
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5476
Practice Address - Country:US
Practice Address - Phone:410-356-0300
Practice Address - Fax:410-356-0309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD44024207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD091NMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER