Provider Demographics
NPI:1336197359
Name:HEMESATH, JAMES F (CRNA)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:F
Last Name:HEMESATH
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:P O BOX 2429
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-2429
Mailing Address - Country:US
Mailing Address - Phone:843-651-2624
Mailing Address - Fax:843-357-4940
Practice Address - Street 1:1118 FAIRINGTON DR
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365-8913
Practice Address - Country:US
Practice Address - Phone:937-492-3755
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-131349367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000374777OtherANTHEM BCBS
OH0753902Medicaid
OH0753902Medicaid