Provider Demographics
NPI:1619075314
Name:ASSOCIATED ANESTHESIOLOGIST OF SPRINGFIELD
Entity type:Organization
Organization Name:ASSOCIATED ANESTHESIOLOGIST OF SPRINGFIELD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-298-5333
Mailing Address - Street 1:3033 KETTERING BLVD
Mailing Address - Street 2:SUITE 213
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45439-1962
Mailing Address - Country:US
Mailing Address - Phone:937-298-5333
Mailing Address - Fax:
Practice Address - Street 1:2685 E HIGH ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45505-1412
Practice Address - Country:US
Practice Address - Phone:937-298-5333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty