Manuel A Colon-dejesus, MD | |
100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | |
(910) 450-4300 | |
Not Available |
Full Name | Manuel A Colon-dejesus |
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Gender | Male |
Speciality | Anesthesiology |
Location | 100 Brewster Blvd, Camp Lejeune, North Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1083702427 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207LP2900X | Anesthesiology - Pain Medicine | 9812 (North Dakota) | Secondary |
207L00000X | Anesthesiology | 46838 (Georgia) | Primary |
Entity Name | Georgia Group Services, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1093947236 PECOS PAC ID: 0840338018 Enrollment ID: O20091109000203 |
Entity Name | Mak Anesthesia Holdings, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1912452939 PECOS PAC ID: 4284917204 Enrollment ID: O20170216001563 |
Entity Name | Mak Anesthesia Northside Affiliates Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1609390103 PECOS PAC ID: 7315203718 Enrollment ID: O20171116002499 |
Entity Name | Rome Anesthesia Services Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740777317 PECOS PAC ID: 8921355504 Enrollment ID: O20180727002778 |
Mailing Address | Practice Location Address |
---|---|
Manuel A Colon-dejesus, MD 801 Broadway N, Fargo, ND 58102-3641 Ph: (701) 234-5621 | Manuel A Colon-dejesus, MD 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 Ph: (910) 450-4300 |
Jason Fleenor, Anesthesiology Medicare: Medicare Enrolled Practice Location: 100 Brewster Blvd, Camp Lejeune, NC 28547 Phone: 910-450-4357 | |
Robert Brett Goy, D.O. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 100 Brewster Blvd, Camp Lejeune, NC 28547 Phone: 910-450-4159 Fax: 910-450-4194 | |
Andrew Clifford Graf, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 100 Brewster Blvd, Camp Lejeune, NC 28547 Phone: 910-450-4719 | |
Dr. Carlos Hermes Casamalhuapa, M.D. Anesthesiology Medicare: Medicare Enrolled Practice Location: 100 Brewster Blvd, Camp Lejeune, NC 28547 Phone: 910-450-4357 | |
Dr. Michael Andrew Lee, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 100 Brewster Blvd, Camp Lejeune, NC 28547 Phone: 910-450-4786 | |
Nicholas Jordan Reaves, M.D. Anesthesiology Medicare: Medicare Enrolled Practice Location: 100 Brewster Blvd, Camp Lejeune, NC 28547 Phone: 908-448-7842 |