Organization
MIDWEST ANESTHESIA CARE INC
Active
Other names
MIDWEST ANESTHESIA CARE LTD
Organization subpart
No
Provider details
NPI number
Authorized official
MARK PANTHER CRNA (PARTNER)
(319) 376-2218
Entity
Organization
Contact information
Practice address
5445 AVENUE O, FORT MADISON, IA 52627-9611
(319) 372-6530
Mailing address
400 E 10TH ST, WACONIA, MN 55387-4552
(952) 442-9770
(952) 442-3630
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14313
BLUE CROSS OF IA
IA
Enumeration date
03/10/2006
Last updated
01/22/2008
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