Provider Demographics
NPI:1285717587
Name:MIDWEST ANESTHESIA INC.
Entity type:Organization
Organization Name:MIDWEST ANESTHESIA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ANESTHESIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-653-9399
Mailing Address - Street 1:PO BOX 822344
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-2344
Mailing Address - Country:US
Mailing Address - Phone:908-653-9399
Mailing Address - Fax:
Practice Address - Street 1:450 N NEW BALLAS RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6835
Practice Address - Country:US
Practice Address - Phone:908-653-9399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207L00000X
MO207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOCP2267OtherRR MEDICARE
ILCG7129OtherRR MEDICARE
MO000011041OtherMEDICARE
MO000060064OtherMEDICARE-CRNA
MO1372OtherBLUE CROSS
MO509150108Medicaid