Provider Demographics
NPI:1700061652
Name:ATLANTIC ANESTHESIA, P.C.
Entity Type:Organization
Organization Name:ATLANTIC ANESTHESIA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMER
Authorized Official - Middle Name:
Authorized Official - Last Name:AL-TABBAA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-480-9060
Mailing Address - Street 1:PO BOX 96
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04243-0096
Mailing Address - Country:US
Mailing Address - Phone:800-720-1664
Mailing Address - Fax:207-753-2020
Practice Address - Street 1:100 MORSE ST
Practice Address - Street 2:EASTERN MASSACHUSETTS SURGERY CENTER
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-4679
Practice Address - Country:US
Practice Address - Phone:617-480-9060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty