Provider Demographics
NPI:1306636279
Name:HOLY CROSS ANESTHESIOLOGY ASSOCIATE PA
Entity type:Organization
Organization Name:HOLY CROSS ANESTHESIOLOGY ASSOCIATE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GROUP CONTACT
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-942-8799
Mailing Address - Street 1:PO BOX 64605
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4605
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7625 MAPLE LAWN BLVD STE 1
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:MD
Practice Address - Zip Code:20759-2565
Practice Address - Country:US
Practice Address - Phone:301-754-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOLY CROSS ANESTHESIOLOGY ASSOCIATE PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty