Organization
BELLEVUE ANESTHESIA ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL POTTER MD (OWNER)
(419) 483-4040
Entity
Organization
Contact information
Practice address
1400 W MAIN ST, BELLEVUE, OH 44811-9088
(419) 483-4040
Mailing address
PO BOX 684, FREMONT, OH 43420-0684
(419) 483-4040
(419) 483-1332
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000207585
ANTHEM
—
05
—
2282382
—
OH
01
—
CJ5258
RRMCR
—
Enumeration date
02/21/2007
Last updated
10/06/2016
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