Provider Demographics
NPI:1639466980
Name:NORTHWEST ALLIED ANESTHESIA INC.
Entity Type:Organization
Organization Name:NORTHWEST ALLIED ANESTHESIA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-255-1846
Mailing Address - Street 1:6255 BARFIELD RD NE
Mailing Address - Street 2:SUITE 175
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4319
Mailing Address - Country:US
Mailing Address - Phone:404-255-1846
Mailing Address - Fax:404-255-1831
Practice Address - Street 1:6255 BARFIELD RD NE
Practice Address - Street 2:SUITE 175
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-4319
Practice Address - Country:US
Practice Address - Phone:404-255-1846
Practice Address - Fax:404-255-1831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty