Organization
AMBULATORY ANESTHESIA SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID DEMANGONE M.D. (OWNER)
(440) 944-1414
Entity
Organization
Contact information
Practice address
6025 COMMERCE CIR, SUITE 2, WILLOUGHBY, OH 44094-9668
(440) 944-1414
(440) 944-1445
Mailing address
PO BOX 5100, MENTOR, OH 44061-5100
(440) 944-1414
(440) 944-1445
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3016426
—
OH
01
—
DQ2764
RAILROAD MEDICARE
OH
Enumeration date
03/25/2008
Last updated
06/17/2011
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