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Organization

CENTRAL WISCONSIN ANESTHESIOLOGY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TIMOTHY MORAN M.D. (PRESIDENT)
(715) 845-5505
Entity
Organization

Contact information

Practice address
425 PINE RIDGE BOULEVARD, SUITE 211, WAUSAU, WI 54401
(715) 845-5505
(715) 848-2884
Mailing address
425 PINE RIDGE BOULEVARD, SUITE 211, WAUSAU, WI 54401
(715) 845-5505
(715) 848-2884

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000039110
HUMANA GOLD MEDICARE
WI
01
43411800
MANAGED HEALTH CARE
WI
05
43411800
WI
01
C01751
MEDICARE RAILROAD GROUP
WI
Enumeration date
07/07/2006
Last updated
05/03/2018
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