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Organization

ADVANCED ANESTHESIA GROUP, PLLC

Active
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Organization

ADVANCED ANESTHESIA GROUP, PLLC

Active
Other names
Advanced Anesthesia
Organization subpart
No

Provider details

NPI number
Authorized official
DUONG THAI LY M.D. (SOLE PROPRIETOR)
(304) 267-5141
Entity
Organization

Contact information

Practice address
1006 TAVERN RD, MARTINSBURG, WV 25401-2864
(304) 267-5141
(304) 267-5140
Mailing address
PO BOX 62556, BALTIMORE, MD 21264-2556
(302) 709-4528
(302) 733-0854

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary

Other

Enumeration date
09/07/2010
Last updated
05/05/2011
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