Organization
ANESTHESIA GROUP EAST PC
Active
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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