Provider Demographics
NPI:1962483552
Name:CLEVELAND ANESTHESIOLOGISTS INC
Entity Type:Organization
Organization Name:CLEVELAND ANESTHESIOLOGISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:A
Authorized Official - Last Name:MUTHS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:423-472-6514
Mailing Address - Street 1:PO BOX 3090
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37320-3090
Mailing Address - Country:US
Mailing Address - Phone:423-472-6513
Mailing Address - Fax:423-476-2062
Practice Address - Street 1:2080 CHAMBLISS AVE NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-3894
Practice Address - Country:US
Practice Address - Phone:423-472-6514
Practice Address - Fax:423-476-2062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN3604470Medicare ID - Type Unspecified
IN3372702Medicare ID - Type Unspecified