Basic Information
Provider Information
NPI: 1073817870
EntityType: 2
ReplacementNPI:  
OrganizationName: ANESTHESIA SOLUTIONS, PC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 400 E 10TH ST
Address2:  
City: WACONIA
State: MN
PostalCode: 553874552
CountryCode: US
TelephoneNumber: 9524429770
FaxNumber: 9524423620
Practice Location
Address1: 540 DEADWOOD AVE
Address2: SUITE 112
City: RAPID CITY
State: SD
PostalCode: 577020395
CountryCode: US
TelephoneNumber: 6057167425
FaxNumber: 9524423620
Other Information
ProviderEnumerationDate: 01/07/2011
LastUpdateDate: 01/13/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: SCHWIESOW
AuthorizedOfficialFirstName: JOEL
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 6057167425
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: CRNA
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X  Y193400000X SINGLE SPECIALTY GROUPPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


Home