Organization
FIRST STATE ANESTHESIA SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THIRUMALESHAWAR KANCHANA M.D. (PHYSICIAN COORDINATOR)
(302) 225-2380
Entity
Organization
Contact information
Practice address
4923 OGLETOWN STANTON RD, SUITE 100, NEWARK, DE 19713-2081
(302) 225-2380
(302) 225-2388
Mailing address
PO BOX 6385, WILMINGTON, DE 19804-0985
(302) 225-2380
(302) 225-2388
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2818802000
AMERIHEALTH/KEYSTONE
—
01
—
7567859
AETNA
—
01
—
DG28116
RAILROAD MEDICARE
—
Enumeration date
01/22/2007
Last updated
06/13/2008
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