Organization
CARDIAC ANESTHESIA PLUS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY J. SHY (OFFICE MANAGER)
(304) 399-0137
Entity
Organization
Contact information
Practice address
2900 1ST AVE, #6019, HUNTINGTON, WV 25702-1241
(304) 399-0137
(304) 399-0138
Mailing address
PO BOX 8225, HUNTINGTON, WV 25705-0225
(304) 399-0137
(304) 399-0138
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0209236000
—
WV
01
—
204052
BLACK LUNG
—
05
—
2473130
—
OH
01
—
DB7669
RAILROAD MEDICARE
—
Enumeration date
09/20/2006
Last updated
08/22/2020
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