Organization
MEDSTAR HEALTH ANESTHESIA SERVICES A, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC R. WAGNER (PRESIDENT)
(410) 772-6595
Entity
Organization
Contact information
Practice address
5601 LOCH RAVEN BLVD, BALTIMORE, MD 21239-2905
(410) 532-8000
Mailing address
PO BOX 1123, JACKSON, MI 49204-1123
(800) 242-1131
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
02/05/2007
Last updated
07/29/2008
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