Provider Demographics
NPI:1518412782
Name:GARRETT ANESTHESIA & PAIN MGMT
Entity type:Organization
Organization Name:GARRETT ANESTHESIA & PAIN MGMT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-362-7718
Mailing Address - Street 1:957 NATIONAL HWY FL 1
Mailing Address - Street 2:
Mailing Address - City:LAVALE
Mailing Address - State:MD
Mailing Address - Zip Code:21502-7356
Mailing Address - Country:US
Mailing Address - Phone:240-362-7718
Mailing Address - Fax:240-362-7731
Practice Address - Street 1:957 NATIONAL HWY FL 1
Practice Address - Street 2:
Practice Address - City:LAVALE
Practice Address - State:MD
Practice Address - Zip Code:21502-7356
Practice Address - Country:US
Practice Address - Phone:240-362-7718
Practice Address - Fax:240-362-7731
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GARRETT ANESTHESIA & PAIN MGMT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-08-17
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty