Organization
SALEM PROFESSIONAL ANESTHESIA SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES PETER NITZ CRNA (PRESIDENT)
(336) 998-3396
Entity
Organization
Contact information
Practice address
3812 N ELM ST, GREENSBORO, NC 27455-2596
(336) 294-1833
(336) 998-2889
Mailing address
128 PEACHTREE LN, SUITE B, ADVANCE, NC 27006-6782
(336) 998-3396
(336) 998-2889
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0264U
BCBS
NC
01
—
16186
PARTNERS
NC
05
—
890264U
—
NC
Enumeration date
08/13/2006
Last updated
07/30/2007
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