Organization
OPHTHALMIC ANESTHESIA TEAM PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GENE GERBERDING CRNA (PRESIDENT)
(316) 681-2020
Entity
Organization
Contact information
Practice address
6100 EAST CENTRAL, STE 5, WICHITA, KS 67212
(316) 681-2020
Mailing address
PO BOX 388, NEWTON, KS 67114-0388
(316) 281-3700
(316) 282-4322
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111237
BCBS
KS
05
—
200376810A
—
KS
Enumeration date
06/20/2006
Last updated
08/27/2008
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