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Organization

ANESTHESIA GROUP EAST PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARC E BLOOMSTON MD (SECRETARY-TREASURER)
(205) 838-3055
Entity
Organization

Contact information

Practice address
52 MEDICAL PARK DR E, SUITE 321, BIRMINGHAM, AL 35235-3430
(205) 838-3055
(205) 838-3517
Mailing address
52 MEDICAL PARK DR E, SUITE 321, BIRMINGHAM, AL 35235-3430
(205) 838-3055
(205) 838-3517

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000060232
AL
01
C232
BLUE SHIELD OF AL
AL
Enumeration date
09/30/2005
Last updated
03/15/2010
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