Organization
AMBULATORY SURGERY ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BHUVANENDRAM INDRAKRISHNAN MD (SOLE MEMBER)
(678) 377-8252
Entity
Organization
Contact information
Practice address
475 PHILIP BLVD, SUITE 304, LAWRENCEVILLE, GA 30045-8737
(678) 377-8252
Mailing address
PO BOX 8846, GREENSBORO, NC 27419-0846
(336) 553-1659
(336) 553-3994
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
10/29/2007
Last updated
10/30/2007
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