Provider Demographics
NPI:1578841714
Name:MORNINGSTAR ANESTHESIA CONSULTANTS LLC
Entity Type:Organization
Organization Name:MORNINGSTAR ANESTHESIA CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:L
Authorized Official - Last Name:SEAL
Authorized Official - Suffix:III
Authorized Official - Credentials:CRNA
Authorized Official - Phone:586-264-3500
Mailing Address - Street 1:6985 MILLER DRIVE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092
Mailing Address - Country:US
Mailing Address - Phone:586-264-3500
Mailing Address - Fax:586-264-3868
Practice Address - Street 1:5085 MONROE ST
Practice Address - Street 2:SUITE B
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3455
Practice Address - Country:US
Practice Address - Phone:586-264-3500
Practice Address - Fax:586-264-3868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-21
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH017530Medicare PIN