Provider Demographics
NPI:1922705375
Name:KLB ANESTHESIOLOGISTS LLC
Entity Type:Organization
Organization Name:KLB ANESTHESIOLOGISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAVEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KONDAMURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-689-9378
Mailing Address - Street 1:1001 WATERVILLE COURT
Mailing Address - Street 2:
Mailing Address - City:DYER
Mailing Address - State:IN
Mailing Address - Zip Code:46311
Mailing Address - Country:US
Mailing Address - Phone:219-689-9378
Mailing Address - Fax:219-836-6454
Practice Address - Street 1:315 WEST 89TH STREET
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410
Practice Address - Country:US
Practice Address - Phone:219-757-5275
Practice Address - Fax:219-836-6454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty