MERCY ANESTHESIOLOGY ASSOCIATES, P.A.

Provider Demographics

• NPI: 1245311307
• Name: MERCY ANESTHESIOLOGY ASSOCIATES, P.A.
• Entity type: Organization
• Organization Name: MERCY ANESTHESIOLOGY ASSOCIATES, P.A.
• Authorized Official - Title/Position: PRESIDENT
• Authorized Official - First Name: JUNG-IN
• Authorized Official - Last Name: LEE
• Authorized Official - Credentials: MD
• Authorized Official - Phone: 410-659-0689
• Mailing Address - Street 1: 341 N CALVERT ST
• Mailing Address - Street 2: LOWER LEVEL
• Mailing Address - City: BALTIMORE
• Mailing Address - State: MD
• Mailing Address - Zip Code: 21202-3633
• Mailing Address - Country: US
• Mailing Address - Phone: 410-659-0689
• Practice Address - Street 1: 341 N CALVERT ST
• Practice Address - Street 2: LOWER LEVEL
• Practice Address - City: BALTIMORE
• Practice Address - State: MD
• Practice Address - Zip Code: 21202-3633
• Practice Address - Country: US
• Practice Address - Phone: 410-659-0689
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-10-17
• Last Update Date: 2010-01-13

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	207L00000X	Allopathic & Osteopathic Physicians	Anesthesiology		Group - Single Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
MD	416515200	Medicaid
MD	009976700	Medicaid
MD	41012190	Medicaid
MD	416516100	Medicaid
MD	G40688	Medicare UPIN
MD	E28715	Medicare UPIN
MD	OTH000	Medicare UPIN
MD	H32365	Medicare UPIN
MD	D71971	Medicare UPIN
MD	D71999	Medicare UPIN
MD	G06595	Medicare UPIN
MD	454MN960	Medicare UPIN
MD	D86035	Medicare UPIN
MD	416515200	Medicaid
MD	416516100	Medicaid
MD	1154432516	Medicare PIN
MD	F61670	Medicare UPIN
MD	G68794	Medicare UPIN
MD	F59970	Medicare UPIN
MD	F66960	Medicare UPIN
MD	41012190	Medicaid
MD	JQ06	Medicare PIN
MD	F48261	Medicare UPIN
MD	D72272	Medicare UPIN
MD	G55938	Medicare UPIN
MD	G55937	Medicare UPIN
MD	1467593376	Medicare PIN
MD	1609808252	Medicare PIN