Provider Demographics
NPI:1306466123
Name:SHENANDOAH ANESTHESIA & RESEARCH SERVICES , PLLC
Entity type:Organization
Organization Name:SHENANDOAH ANESTHESIA & RESEARCH SERVICES , PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KHALID
Authorized Official - Middle Name:
Authorized Official - Last Name:ATHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-276-1910
Mailing Address - Street 1:1912 SEPTEMBER CT
Mailing Address - Street 2:
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701-3313
Mailing Address - Country:US
Mailing Address - Phone:888-276-1910
Mailing Address - Fax:
Practice Address - Street 1:541 SUNSET LN STE 201
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-3979
Practice Address - Country:US
Practice Address - Phone:888-276-1910
Practice Address - Fax:540-829-8191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1891995510Medicaid