Provider Demographics
NPI:1821035775
Name:OBAN ANESTHESIA CONSULTANTS, PLLC
Entity Type:Organization
Organization Name:OBAN ANESTHESIA CONSULTANTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:HANSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-291-7781
Mailing Address - Street 1:2485 HEMBY LN
Mailing Address - Street 2:SUITE A
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-3701
Mailing Address - Country:US
Mailing Address - Phone:888-549-1922
Mailing Address - Fax:888-864-1737
Practice Address - Street 1:500 LAUCHWOOD DR
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-5501
Practice Address - Country:US
Practice Address - Phone:910-291-7781
Practice Address - Fax:910-291-7435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNPB052OtherSC MEDICAID
NC015T4OtherNC BLUE CROSS
NC89015T4Medicaid
NC2337601Medicare ID - Type Unspecified