Organization
PHYSICIANS' AMBULATORY ANESTHESIA SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMA MOHMOUD M.D. (PRESIDENT)
(314) 283-8498
Entity
Organization
Contact information
Practice address
12266 DEPAUL DRIVE, BRIDGETON, MO 63044-2514
(314) 291-7500
(314) 291-7501
Mailing address
1860 GATEMONT DR, CHESTERFIELD, MO 63017-8012
(314) 283-8498
(636) 220-4132
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
06/27/2011
Last updated
06/27/2011
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