Organization
METHODIST ANESTHESIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY CAPARROS (AUTHORIZED REPRESENTATIVE)
(219) 738-4929
Entity
Organization
Contact information
Practice address
8701 BROADWAY, MERRILLVILLE, IN 46410-7035
(219) 738-4929
Mailing address
255 W MICHIGAN AVE, JACKSON, MI 49201-2218
(517) 787-6440
(517) 787-4146
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
05/28/2006
Last updated
03/05/2008
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