Duong Thai Ly, MD | |
1006 Tavern Rd, Martinsburg, WV 25401-2864 | |
(304) 267-5141 | |
(304) 267-5140 |
Full Name | Duong Thai Ly |
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Gender | Male |
Speciality | Anesthesiology |
Location | 1006 Tavern Rd, Martinsburg, West Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1124032917 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | D69151 (Maryland) | Secondary |
207L00000X | Anesthesiology | 24121 (West Virginia) | Primary |
207L00000X | Anesthesiology | 0101246849 (Virginia) | Secondary |
Entity Name | First Colonies Anesthesia Associates, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740218767 PECOS PAC ID: 8426039744 Enrollment ID: O20040525000119 |
Mailing Address | Practice Location Address |
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Duong Thai Ly, MD Po Box 62556, Baltimore, MD 21264-2556 Ph: (302) 709-4528 | Duong Thai Ly, MD 1006 Tavern Rd, Martinsburg, WV 25401-2864 Ph: (304) 267-5141 |
Satish Kumar Menon, DO Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 94 Old Mill Rd, Martinsburg, WV 25401 Phone: 304-264-8933 Fax: 304-264-8846 | |
Sarah Mclellan, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2000 Foundation Way, Suite 3400, Martinsburg, WV 25401 Phone: 304-264-1000 | |
Linda Jones, CRNA Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 94 Old Mill Rd, Martinsburg, WV 25401 Phone: 304-264-8933 Fax: 304-264-8846 | |
Paulette Pickett, CRNA Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 94 Old Mill Rd, Martinsburg, WV 25401 Phone: 304-264-8933 Fax: 304-264-8846 | |
Danilo J Gervacio, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 94 Old Mill Rd, Martinsburg, WV 25401 Phone: 304-264-8933 Fax: 304-264-8846 | |
Phillip Nicodemus, CRNA Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 94 Old Mill Rd, Martinsburg, WV 25401 Phone: 304-264-8933 Fax: 304-264-8846 |