Provider Demographics
NPI:1831676253
Name:MEDINA ANESTHESIA ASSOCIATES, INC
Entity Type:Organization
Organization Name:MEDINA ANESTHESIA ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANH-STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-243-0736
Mailing Address - Street 1:3443 MEDINA RD STE 105
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-5361
Mailing Address - Country:US
Mailing Address - Phone:330-952-1737
Mailing Address - Fax:
Practice Address - Street 1:3443 MEDINA RD STE 105
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-5361
Practice Address - Country:US
Practice Address - Phone:330-952-1737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-27
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHGA.0006211223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0004XDental ProvidersDentistDentist AnesthesiologistGroup - Single Specialty