Provider Demographics
NPI:1689990871
Name:AMBULATORY ANESTHESIA OF NORTHWEST INDIANA, LLC
Entity Type:Organization
Organization Name:AMBULATORY ANESTHESIA OF NORTHWEST INDIANA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-937-5947
Mailing Address - Street 1:7 PARKWAY CTR
Mailing Address - Street 2:SUITE 375
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-3704
Mailing Address - Country:US
Mailing Address - Phone:412-937-5947
Mailing Address - Fax:770-237-1492
Practice Address - Street 1:1101 GLENDALE BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-3767
Practice Address - Country:US
Practice Address - Phone:219-462-6144
Practice Address - Fax:770-237-1492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-13
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty