Provider Demographics
NPI:1790816254
Name:AMBULATORY ANESTHESIA SERVICES, PLLC
Entity Type:Organization
Organization Name:AMBULATORY ANESTHESIA SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE COMMITTEE CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHAKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-442-1100
Mailing Address - Street 1:1602 PHYSICIANS DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7363
Mailing Address - Country:US
Mailing Address - Phone:910-442-1100
Mailing Address - Fax:
Practice Address - Street 1:1602 PHYSICIANS DR
Practice Address - Street 2:SUITE 104
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7363
Practice Address - Country:US
Practice Address - Phone:910-442-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Not Answered207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty