Organization
AMBULATORY CARE ANESTHESIA, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH MAGGIONCALDA MD (PRESIDENT)
(843) 692-1026
Entity
Organization
Contact information
Practice address
809 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 692-1062
Mailing address
PO BOX 2013, COLUMBIA, SC 29202-2013
(843) 692-1062
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
367H00000X
Anesthesiologist Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4352
—
SC
Enumeration date
07/23/2006
Last updated
02/08/2010
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