Organization
MISSION COMMUNITY ANESTHESIOLOGY SPECIALISTS LLC
Active
Parent organization
MISSION COMMUNITY ANESTHESIOLOGY SPECIALISTS LLC
Other names
Radiation Oncology
Organization subpart
Yes
Provider details
NPI number
Legal business name
MISSION COMMUNITY ANESTHESIOLOGY SPECIALISTS LLC
Authorized official
MARILYN TATHAM DO (PROVIDER ENROLLMENT)
(828) 651-6595
Entity
Organization
Contact information
Practice address
21 HOSPITAL DR FL 2, ASHEVILLE, NC 28801-4550
(828) 213-1740
Mailing address
PO BOX 603366, CHARLOTTE, NC 28260-3366
(828) 213-1500
(828) 681-1575
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02CG9
BC/BS NC
NC
Enumeration date
11/30/2018
Last updated
12/05/2018
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