Provider Demographics
NPI:1013700343
Name:MEDEX ANESTHESIA INC
Entity type:Organization
Organization Name:MEDEX ANESTHESIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DORA
Authorized Official - Middle Name:
Authorized Official - Last Name:NGWANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-558-7924
Mailing Address - Street 1:106 ABBINGTON RIVER LN
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-8588
Mailing Address - Country:US
Mailing Address - Phone:502-558-7892
Mailing Address - Fax:
Practice Address - Street 1:2685 PEACHTREE PKWY STE 340
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-5900
Practice Address - Country:US
Practice Address - Phone:770-771-5260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty