Maurice Deon Dale, | |
1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 | |
(618) 234-2120 | |
Not Available |
Full Name | Maurice Deon Dale |
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Gender | Male |
Speciality | Emergency Medicine |
Location | 1 Saint Elizabeth Blvd, O Fallon, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1639757958 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 036170338 (Illinois) | Primary |
Entity Name | Pomerene Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770957185 PECOS PAC ID: 5496856270 Enrollment ID: O20160208000863 |
Mailing Address | Practice Location Address |
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Maurice Deon Dale, 525 E Market St, Akron, OH 44304-1619 Ph: () - | Maurice Deon Dale, 1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 Ph: (618) 234-2120 |
Dr. Arthur Sippo, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 103 N Oak St, O Fallon, IL 62269 Phone: 618-624-3368 Fax: 618-624-3387 | |
Maria Galanos, Emergency Medicine Medicare: Medicare Enrolled Practice Location: 103 N Oak St, O Fallon, IL 62269 Phone: 618-624-3368 | |
Vicky Hwang, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 320 E Highway 50, O Fallon, IL 62269 Phone: 618-624-3368 | |
Scott R. Roustio, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 8422 Braeswood Estates Dr, O Fallon, IL 62269 Phone: 618-624-0091 | |
Dr. Faron Fox, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 103 N Oak St, O Fallon, IL 62269 Phone: 618-624-3368 Fax: 618-624-3387 | |
Brian Litland, Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 103 N Oak St, O Fallon, IL 62269 Phone: 618-624-3368 | |
Dr. Dale E Long, D.O Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 103 N Oak St, O Fallon, IL 62269 Phone: 618-624-3368 Fax: 618-624-3387 |