Provider Demographics
NPI:1659488112
Name:ANESTHESIA OF RANDOLPH COUNTY PA
Entity Type:Organization
Organization Name:ANESTHESIA OF RANDOLPH COUNTY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:BUHRMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-683-5284
Mailing Address - Street 1:PO BOX 4174
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27204
Mailing Address - Country:US
Mailing Address - Phone:336-683-5284
Mailing Address - Fax:336-683-5279
Practice Address - Street 1:364 WHITE OAK ST
Practice Address - Street 2:ANESTHESIA DEPARTMENT
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-5434
Practice Address - Country:US
Practice Address - Phone:336-683-5284
Practice Address - Fax:336-683-5279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207L00000X, 207LP2900X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89012ACMedicaid
NC2344722Medicare PIN
NC2618266Medicare PIN