Provider Demographics
NPI:1760437115
Name:MARTINSVILLE ANESTHESIA, PC
Entity Type:Organization
Organization Name:MARTINSVILLE ANESTHESIA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAURICE
Authorized Official - Middle Name:H
Authorized Official - Last Name:BELL
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:540-666-7200
Mailing Address - Street 1:PO BOX 13808
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24037-3808
Mailing Address - Country:US
Mailing Address - Phone:540-666-7200
Mailing Address - Fax:540-670-7101
Practice Address - Street 1:320 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-1900
Practice Address - Country:US
Practice Address - Phone:540-666-7200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VACO9111Medicare PIN