Organization
MIDWEST ANESTHESIA CARE INC
Active
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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