1053677195 NPI number — AMERICAN ANESTHESIOLOGY OF NORTH CAROLINA, PLLC

Table of content: DR. STEVEN GEORGE SHIMOTAKAHARA MD (NPI 1326024738)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053677195 NPI number — AMERICAN ANESTHESIOLOGY OF NORTH CAROLINA, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERICAN ANESTHESIOLOGY OF NORTH CAROLINA, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053677195
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/23/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1305 WALT WHITMAN RD STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MELVILLE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11747-4300
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
754-247-4124
Provider Business Mailing Address Fax Number:
704-248-5537

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1236 HUFFMAN MILL RD
Provider Second Line Business Practice Location Address:
SUITE 2000
Provider Business Practice Location Address City Name:
BURLINGTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
366-585-1770
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/03/2012

Additional Information

Authorized Official

Authorized Official Last Name:
GARRABRANT
Authorized Official First Name:
EDGAR
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/OWNER
Authorized Official Telephone Number:
516-945-3000

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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