Organization
CHAGRIN VALLEY ANESTHESIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN J FITZGERALD MD (PRESIDENT)
(216) 765-0358
Entity
Organization
Contact information
Practice address
3755 ORANGE PL STE 102, BEACHWOOD, OH 44122-4455
(216) 765-0358
(216) 765-0378
Mailing address
3755 ORANGE PL STE 105, BEACHWOOD, OH 44122-4426
(216) 765-0358
(216) 765-0378
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2529660
—
OH
Enumeration date
06/15/2006
Last updated
09/19/2019
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