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Organization

KEYSTONE ANESTHESIA, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DAVIID A FEMOVICH MD (MEMBER)
(814) 677-6700
Entity
Organization

Contact information

Practice address
3744 STATE ROUTE 257, SENECA, PA 16346-3318
(814) 677-6638
(814) 676-1593
Mailing address
3744 STATE ROUTE 257, SENECA, PA 16346-3318
(814) 677-6700
(814) 677-6776

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
580913
BLUE SHIELD
PA
Enumeration date
11/22/2005
Last updated
07/05/2019
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