Organization
SECURUS ANESTHESIA LLC
Active
Organization
SECURUS ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID CHARLES SANTAMORE MD (OWNER PRESIDENT)
(410) 273-9096
Entity
Organization
Contact information
Practice address
1111 BEARDS HILL RD, SUITE 700, ABERDEEN, MD 21001-2232
(410) 273-9096
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
404862800
—
MD
01
—
612371800
US DEPT OF LABOR
MD
Enumeration date
05/08/2007
Last updated
06/29/2015
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