Organization
VIKING ANESTHESIA SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL RYAN M.D. (OWNER)
(314) 692-8411
Entity
Organization
Contact information
Practice address
425 N NEW BALLAS RD, SUITE 205, CREVE COEUR, MO 63141-6814
(314) 692-8411
Mailing address
425 N NEW BALLAS RD, SUITE 205, CREVE COEUR, MO 63141-6814
(314) 692-8411
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
104661
MO
Other
Enumeration date
12/02/2014
Last updated
02/10/2015
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