| Maine Childrens Cancer Program | |
|
100 Campus Dr Unit 107 Scarborough ME 04074-9692 | |
| (207) 885-7565 | |
| Not Available |
| Full Name | Maine Childrens Cancer Program |
|---|---|
| Speciality | Pediatrics |
| Location | 100 Campus Dr, Scarborough, Maine |
| Authorized Official Name and Position | Stephen J Kasabian (PRESIDENT) |
| Authorized Official Contact | 2076612000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maine Childrens Cancer Program 300 Southborough Dr Suite 201 South Portland ME 04106-6914 Ph: (207) 661-2000 | Maine Childrens Cancer Program 100 Campus Dr Unit 107 Scarborough ME 04074-9692 Ph: (207) 885-7565 |
| NPI Number | 1073527388 |
|---|---|
| Provider Enumeration Date | 07/29/2006 |
| Last Update Date | 12/13/2022 |
| Certification Date | 12/13/2022 |
| Medicare PECOS PAC ID | 9335043967 |
|---|---|
| Medicare Enrollment ID | O20050401000844 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073527388 | NPI | - | NPPES |
| 126770000 | Medicaid | ME |
| Provider Name | Alison M Samitt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336242585 PECOS PAC ID: 0648184671 Enrollment ID: I20031114000206 |
| Provider Name | Michael P Sullivan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538129994 PECOS PAC ID: 8325941412 Enrollment ID: I20040128000044 |
| Provider Name | Susan A Speckhart |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1407940984 PECOS PAC ID: 6204739212 Enrollment ID: I20040128000679 |
| Provider Name | Joseph T Degrinney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538106679 PECOS PAC ID: 2567355852 Enrollment ID: I20040202000986 |
| Provider Name | Daniel W Chase |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942217237 PECOS PAC ID: 8325022239 Enrollment ID: I20040617000574 |
| Provider Name | Nicole Cherbuliez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932293578 PECOS PAC ID: 0840277455 Enrollment ID: I20040701000907 |
| Provider Name | Donald A Dubois |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588669782 PECOS PAC ID: 0648241778 Enrollment ID: I20040803000985 |
| Provider Name | Steven A Hess |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1427099498 PECOS PAC ID: 2163493735 Enrollment ID: I20040805000774 |
| Provider Name | Mark P Bouchard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023040656 PECOS PAC ID: 2567436264 Enrollment ID: I20040819001113 |
| Provider Name | Elizabeth G Murray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922192491 PECOS PAC ID: 1759322035 Enrollment ID: I20050517000663 |
| Provider Name | Christine M Freme |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225123524 PECOS PAC ID: 6507807674 Enrollment ID: I20050518001203 |
| Provider Name | Eric C Larsen |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1548299548 PECOS PAC ID: 5294780441 Enrollment ID: I20050520000345 |
| Provider Name | Lisa M Almeder |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033238332 PECOS PAC ID: 7911949144 Enrollment ID: I20050526000838 |
| Provider Name | Eric Mukai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750310611 PECOS PAC ID: 4284677097 Enrollment ID: I20050602000841 |
| Provider Name | Robert L Trowbridge |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700926490 PECOS PAC ID: 7315980810 Enrollment ID: I20050606000973 |
| Provider Name | Christopher A Wellins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053407601 PECOS PAC ID: 5991749897 Enrollment ID: I20050613000188 |
| Provider Name | John E Erickson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043289713 PECOS PAC ID: 7012951700 Enrollment ID: I20050614000448 |
| Provider Name | Kathleen A Mcgarr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962432203 PECOS PAC ID: 0648215376 Enrollment ID: I20050623000278 |
| Provider Name | Tina M Piraino |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841221629 PECOS PAC ID: 8325083892 Enrollment ID: I20050624000459 |
| Provider Name | Peggy R Cyr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760584767 PECOS PAC ID: 0042255358 Enrollment ID: I20050627000640 |
| Provider Name | Wendy S Cathcart |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295704971 PECOS PAC ID: 5193760411 Enrollment ID: I20050627000766 |
| Provider Name | Marc P Jacquet |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1740212364 PECOS PAC ID: 1658317847 Enrollment ID: I20050628000840 |
| Provider Name | Benedict J Farino |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104912864 PECOS PAC ID: 1850337619 Enrollment ID: I20050701000082 |
| Provider Name | John R Reynolds |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861426272 PECOS PAC ID: 5991732018 Enrollment ID: I20050720000851 |
| Provider Name | Stephen R Hayes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255369575 PECOS PAC ID: 9133156276 Enrollment ID: I20050720000972 |
| Provider Name | Stacey L Kelley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033188263 PECOS PAC ID: 1557398245 Enrollment ID: I20050725000763 |
| Provider Name | Thomas P Gearan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518073170 PECOS PAC ID: 8325012701 Enrollment ID: I20050729000509 |
| Provider Name | Rebecca B Hemphill |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245268903 PECOS PAC ID: 9032140140 Enrollment ID: I20050829000748 |
| Provider Name | Tevis H Gearan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205942877 PECOS PAC ID: 8224020441 Enrollment ID: I20050928001155 |
| Provider Name | Donald J Medd |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902810294 PECOS PAC ID: 3870528136 Enrollment ID: I20051005000806 |
| Provider Name | Edward M Tumavicus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316973969 PECOS PAC ID: 5698791325 Enrollment ID: I20051021000123 |
| Provider Name | Isabella Stumpf |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1184661548 PECOS PAC ID: 8022036615 Enrollment ID: I20051102000593 |
| Provider Name | Danyelle M. Tierney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134298813 PECOS PAC ID: 7012937725 Enrollment ID: I20051123000650 |
| Provider Name | Diane H Cormier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235221318 PECOS PAC ID: 2567468242 Enrollment ID: I20061020000282 |
| Provider Name | Cynthia A Atkinson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487753125 PECOS PAC ID: 8729086905 Enrollment ID: I20061122000365 |
| Provider Name | Ashish Rohira |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326084716 PECOS PAC ID: 7416953971 Enrollment ID: I20061202000134 |
| Provider Name | Kenneth L Weerasinghe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447269006 PECOS PAC ID: 6608875331 Enrollment ID: I20061207000100 |
| Provider Name | G Sean Callender |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932117678 PECOS PAC ID: 7214980358 Enrollment ID: I20070104000100 |
| Provider Name | Brett Loffredo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295809911 PECOS PAC ID: 0547352866 Enrollment ID: I20070816000362 |
| Provider Name | Reynerio Lanoy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740405505 PECOS PAC ID: 5092809830 Enrollment ID: I20070924000502 |
| Provider Name | Emily W Demetriou |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1558439414 PECOS PAC ID: 4587751995 Enrollment ID: I20071101000412 |
| Provider Name | Maura A Mcdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710167556 PECOS PAC ID: 4688759657 Enrollment ID: I20080314000396 |
| Provider Name | Stanley Chaleff |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1871549451 PECOS PAC ID: 6608808043 Enrollment ID: I20080411000049 |
| Provider Name | Peter G Amann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639107840 PECOS PAC ID: 5698848596 Enrollment ID: I20080725000427 |
| Provider Name | Clifford B Rubin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942375225 PECOS PAC ID: 4981779618 Enrollment ID: I20080814000763 |
| Provider Name | Michele B Delenick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821166786 PECOS PAC ID: 8921176546 Enrollment ID: I20081009000641 |
| Provider Name | Jessica H Weber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255580429 PECOS PAC ID: 4385704923 Enrollment ID: I20081126000594 |
| Provider Name | Elizabeth B Eisenhardt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194893982 PECOS PAC ID: 9830244672 Enrollment ID: I20090901000108 |
| Provider Name | Sarah A M Hallen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033221817 PECOS PAC ID: 2860548849 Enrollment ID: I20090916000162 |
| Provider Name | Timothy C Baum |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922077601 PECOS PAC ID: 1658454608 Enrollment ID: I20091125000060 |
| Provider Name | Joel L Botler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891764577 PECOS PAC ID: 1254470685 Enrollment ID: I20091125000074 |
| Provider Name | James H Zeitlin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194794859 PECOS PAC ID: 2466535422 Enrollment ID: I20091216000555 |
| Provider Name | Ioan M Cosma |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1356540454 PECOS PAC ID: 8729102751 Enrollment ID: I20100827000732 |
| Provider Name | Ana Rossi |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1629277710 PECOS PAC ID: 2264613330 Enrollment ID: I20110222001003 |
| Provider Name | Beth E Eilers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659674133 PECOS PAC ID: 2860673829 Enrollment ID: I20110223000937 |
| Provider Name | Eric S Haskell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770742439 PECOS PAC ID: 0648449769 Enrollment ID: I20110808000058 |
| Provider Name | Ellis A Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215196985 PECOS PAC ID: 7113196064 Enrollment ID: I20110809000905 |
| Provider Name | Thomas Q Reynolds |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1811064900 PECOS PAC ID: 3971772732 Enrollment ID: I20110811000588 |
| Provider Name | Daniel A Meyer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871751164 PECOS PAC ID: 6507042520 Enrollment ID: I20110830000700 |
| Provider Name | Kathryn M Diamond-falk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306045034 PECOS PAC ID: 8224209465 Enrollment ID: I20110920000852 |
| Provider Name | Michael Roy |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1134227994 PECOS PAC ID: 5991782666 Enrollment ID: I20120203000461 |
| Provider Name | Claudia R Picone |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1720193469 PECOS PAC ID: 0941241731 Enrollment ID: I20120227000108 |
| Provider Name | Alexis A Cavic |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699903047 PECOS PAC ID: 2860658002 Enrollment ID: I20120717000011 |
| Provider Name | Brandei K Wingard |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1033318753 PECOS PAC ID: 8921264193 Enrollment ID: I20120717000284 |
| Provider Name | Cameron Price |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790938488 PECOS PAC ID: 6507014065 Enrollment ID: I20120907000438 |
| Provider Name | Hilamber Subba |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659504751 PECOS PAC ID: 7911156781 Enrollment ID: I20121011000470 |
| Provider Name | Aaron R Weiss |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1013945708 PECOS PAC ID: 8426061995 Enrollment ID: I20121019000438 |
| Provider Name | Randolph S Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639337496 PECOS PAC ID: 3173712957 Enrollment ID: I20121022000042 |
| Provider Name | Kelly L Osborne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699023432 PECOS PAC ID: 2062663164 Enrollment ID: I20121120000243 |
| Provider Name | Nichole M Reader |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316297690 PECOS PAC ID: 7214177765 Enrollment ID: I20130708000090 |
| Provider Name | Elizabeth L Herrle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801116702 PECOS PAC ID: 0749422608 Enrollment ID: I20130806000748 |
| Provider Name | Christine A Kleinman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043473457 PECOS PAC ID: 3779752829 Enrollment ID: I20130911000226 |
| Provider Name | Christina M Dematteo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033438254 PECOS PAC ID: 6204070279 Enrollment ID: I20130912000300 |
| Provider Name | Sarah M Bray |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457678518 PECOS PAC ID: 7911141585 Enrollment ID: I20130920000533 |
| Provider Name | Alana M Rose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083056253 PECOS PAC ID: 6800021460 Enrollment ID: I20131107000168 |
| Provider Name | Janet D Mcculley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023139177 PECOS PAC ID: 6901992924 Enrollment ID: I20140304000793 |
| Provider Name | Katie B Stokem |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982990412 PECOS PAC ID: 7810121522 Enrollment ID: I20140625001004 |
| Provider Name | Jennifer H Goldberg |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1568669919 PECOS PAC ID: 9739361106 Enrollment ID: I20140930000886 |
| Provider Name | Samantha Jo Doe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982093753 PECOS PAC ID: 8527385012 Enrollment ID: I20150320001828 |
| Provider Name | Ross Isacke |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1861753212 PECOS PAC ID: 8325272255 Enrollment ID: I20150615002112 |
| Provider Name | Scott Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619241908 PECOS PAC ID: 5799097846 Enrollment ID: I20150702001714 |
| Provider Name | Jennifer Marsidi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275713588 PECOS PAC ID: 1759470123 Enrollment ID: I20150708001948 |
| Provider Name | Hani T Jarawan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154682458 PECOS PAC ID: 5193959807 Enrollment ID: I20150708002021 |
| Provider Name | Emily I Zarookian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265794044 PECOS PAC ID: 3072747989 Enrollment ID: I20150724011797 |
| Provider Name | Alison N Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578825352 PECOS PAC ID: 7911131743 Enrollment ID: I20150729008024 |
| Provider Name | Caitlin Costigan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740662832 PECOS PAC ID: 4981918653 Enrollment ID: I20150810000562 |
| Provider Name | Benjamina Dolinsek Razsa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831450261 PECOS PAC ID: 8325274533 Enrollment ID: I20150818005956 |
| Provider Name | Robert A Fulton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023375953 PECOS PAC ID: 8820243322 Enrollment ID: I20150903000645 |
| Provider Name | Marshall R Chamberlin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003044488 PECOS PAC ID: 8426206863 Enrollment ID: I20151022001228 |
| Provider Name | Laurel M Knapp |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720372626 PECOS PAC ID: 8224347729 Enrollment ID: I20151023001319 |
| Provider Name | Laura A Anderson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639439615 PECOS PAC ID: 2264658046 Enrollment ID: I20151023001720 |
| Provider Name | Donna Guenther |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023120235 PECOS PAC ID: 2567446362 Enrollment ID: I20151117001839 |
| Provider Name | Kathryn M Brouillette |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881980332 PECOS PAC ID: 0143456244 Enrollment ID: I20151203002044 |
| Provider Name | Patricia M Rand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710343777 PECOS PAC ID: 7315242252 Enrollment ID: I20160301002214 |
| Provider Name | Diana J Goodman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1245457514 PECOS PAC ID: 7113182866 Enrollment ID: I20160418000382 |
| Provider Name | Matthew S Buttarazzi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447696422 PECOS PAC ID: 8628210937 Enrollment ID: I20160721000613 |
| Provider Name | Spencer J Powers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518303320 PECOS PAC ID: 0547402844 Enrollment ID: I20160725001178 |
| Provider Name | Caroline E Foust-wright |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669606521 PECOS PAC ID: 6204064322 Enrollment ID: I20160822000659 |
| Provider Name | Lesley B Gordon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215373212 PECOS PAC ID: 5991947376 Enrollment ID: I20160827000103 |
| Provider Name | Christina A Kapala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386080182 PECOS PAC ID: 9234371618 Enrollment ID: I20160827000172 |
| Provider Name | Jason A Helis |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1114215043 PECOS PAC ID: 7719272830 Enrollment ID: I20160827000363 |
| Provider Name | Timothy N Botler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730525312 PECOS PAC ID: 0547557548 Enrollment ID: I20160919001948 |
| Provider Name | Eliza R Bullis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518257682 PECOS PAC ID: 0244544922 Enrollment ID: I20160921000492 |
| Provider Name | Donna L Lawlor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710067087 PECOS PAC ID: 9638349541 Enrollment ID: I20161006002029 |
| Provider Name | Katherine T Liu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1891056149 PECOS PAC ID: 1557595337 Enrollment ID: I20161018000417 |
| Provider Name | Scott P Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992048334 PECOS PAC ID: 9830326552 Enrollment ID: I20161026001932 |
| Provider Name | Christopher Abbott |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982043329 PECOS PAC ID: 5597043521 Enrollment ID: I20161026002053 |
| Provider Name | Waseem Chaudhry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912203290 PECOS PAC ID: 5193951259 Enrollment ID: I20170123000756 |
| Provider Name | Celeste F Danforth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770710279 PECOS PAC ID: 9830236736 Enrollment ID: I20170308000130 |
| Provider Name | Brandy E Kulaga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134364367 PECOS PAC ID: 2769767326 Enrollment ID: I20170322000050 |
| Provider Name | Elizabeth Kasny Sundborg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750835377 PECOS PAC ID: 0446548424 Enrollment ID: I20170405001582 |
| Provider Name | Sebastian M Jablonski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093151094 PECOS PAC ID: 7618119918 Enrollment ID: I20170505001840 |
| Provider Name | John L Daggett |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1881006831 PECOS PAC ID: 9739486259 Enrollment ID: I20170508001244 |
| Provider Name | Caleb Schmid |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164834354 PECOS PAC ID: 8729204698 Enrollment ID: I20170621001981 |
| Provider Name | Nicholas D Dupuis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104238567 PECOS PAC ID: 1658649173 Enrollment ID: I20170623002180 |
| Provider Name | Zachary E Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780944074 PECOS PAC ID: 2365762309 Enrollment ID: I20170801000348 |
| Provider Name | Nicholas E Perros |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518379635 PECOS PAC ID: 6406072339 Enrollment ID: I20170810001896 |
| Provider Name | Joshua A Keller |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1578975439 PECOS PAC ID: 5991921645 Enrollment ID: I20170811001248 |
| Provider Name | Evan M Barnathan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558773994 PECOS PAC ID: 9537385570 Enrollment ID: I20170818000300 |
| Provider Name | Andreas Pm Thyssen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215373279 PECOS PAC ID: 7113169376 Enrollment ID: I20170829000592 |
| Provider Name | Evdokia Eleftheriou |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346504545 PECOS PAC ID: 9436456662 Enrollment ID: I20170829003626 |
| Provider Name | Allison M Caldwell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881031904 PECOS PAC ID: 9234358326 Enrollment ID: I20170908000088 |
| Provider Name | Elbert A White |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1811954324 PECOS PAC ID: 0648206359 Enrollment ID: I20170912000870 |
| Provider Name | Jared J Cassin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780094243 PECOS PAC ID: 6002180965 Enrollment ID: I20170916000540 |
| Provider Name | Amy E Riviere |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295147429 PECOS PAC ID: 5193941888 Enrollment ID: I20170918002762 |
| Provider Name | Christopher Link |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1336467182 PECOS PAC ID: 4082998133 Enrollment ID: I20170918003121 |
| Provider Name | Lewis B Richards |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871939645 PECOS PAC ID: 2567604721 Enrollment ID: I20170919002191 |
| Provider Name | Grace L Price |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154735967 PECOS PAC ID: 2567736846 Enrollment ID: I20170926000834 |
| Provider Name | Morgan S Kellogg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730522079 PECOS PAC ID: 8022303783 Enrollment ID: I20171004002901 |
| Provider Name | Bridgid Neptune |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831619170 PECOS PAC ID: 0648530212 Enrollment ID: I20180131001411 |
| Provider Name | Deny Grace Talakshi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881109072 PECOS PAC ID: 4082974159 Enrollment ID: I20180209001355 |
| Provider Name | Harmony E Stratton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457672792 PECOS PAC ID: 6305013632 Enrollment ID: I20180410001924 |
| Provider Name | Margaret W Curran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891181285 PECOS PAC ID: 9032422613 Enrollment ID: I20180605001983 |
| Provider Name | Sei-gyung K Sze |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1831416452 PECOS PAC ID: 1759523699 Enrollment ID: I20180607002795 |
| Provider Name | Ryan Nemon Best |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699169581 PECOS PAC ID: 9830403906 Enrollment ID: I20180723002582 |
| Provider Name | Perri Michelle Huitt |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1194139691 PECOS PAC ID: 8426277237 Enrollment ID: I20180813000705 |
| Provider Name | Erin K Shefferly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538566393 PECOS PAC ID: 0345566808 Enrollment ID: I20180827000517 |
| Provider Name | Arthur J Kehas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952741811 PECOS PAC ID: 0648561647 Enrollment ID: I20180827001151 |
| Provider Name | Christopher E Withers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942612916 PECOS PAC ID: 9931325602 Enrollment ID: I20180828003564 |
| Provider Name | Monica Thim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093133993 PECOS PAC ID: 7810115292 Enrollment ID: I20180829001622 |
| Provider Name | Zhyldyz T Kabaeva |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730507336 PECOS PAC ID: 0941426092 Enrollment ID: I20180829002689 |
| Provider Name | Michelle G Thompson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750778809 PECOS PAC ID: 2860709631 Enrollment ID: I20180913001616 |
| Provider Name | Amanda Ra Roberts |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548654544 PECOS PAC ID: 1557675584 Enrollment ID: I20190123001107 |
| Provider Name | Arina R Cadariu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922141969 PECOS PAC ID: 9739144981 Enrollment ID: I20190123002297 |
| Provider Name | Heidi Frutchy Deblock |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1922095892 PECOS PAC ID: 0345212114 Enrollment ID: I20190418000306 |
| Provider Name | Crystal Ann Fox |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528302064 PECOS PAC ID: 4981925815 Enrollment ID: I20190503002165 |
| Provider Name | Raymond M Klein |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821484296 PECOS PAC ID: 7214234905 Enrollment ID: I20190613000927 |
| Provider Name | Samuel Woodworth |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1700235512 PECOS PAC ID: 6800181744 Enrollment ID: I20190731002561 |
| Provider Name | Sean R Lena |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265895502 PECOS PAC ID: 9234424995 Enrollment ID: I20190805002824 |
| Provider Name | Scott Matthew Statman |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104203504 PECOS PAC ID: 5991053886 Enrollment ID: I20190809002440 |
| Provider Name | Nadav L Kastle |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1083051122 PECOS PAC ID: 7618196437 Enrollment ID: I20190821003232 |
| Provider Name | Micheal J Hellen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366805103 PECOS PAC ID: 0648565184 Enrollment ID: I20190826001330 |
| Provider Name | Kasey R Little |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720441595 PECOS PAC ID: 1850689779 Enrollment ID: I20190826002119 |
| Provider Name | Rachael M Burgess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174963136 PECOS PAC ID: 5890026728 Enrollment ID: I20191008001758 |
| Provider Name | Matthew J Turnquist |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255794962 PECOS PAC ID: 8426343187 Enrollment ID: I20191009002091 |
| Provider Name | Anne V Dean |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1801932884 PECOS PAC ID: 8224198056 Enrollment ID: I20191023001284 |
| Provider Name | Seleipiri Iboroma Seddon Akobo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952763914 PECOS PAC ID: 4981988995 Enrollment ID: I20191206001622 |
| Provider Name | Karen Heard Cushing |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720421217 PECOS PAC ID: 4183859424 Enrollment ID: I20200206001470 |
| Provider Name | Jared Tobolski |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1265889265 PECOS PAC ID: 1254626583 Enrollment ID: I20200211001960 |
| Provider Name | Carla M Canepa |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1336482538 PECOS PAC ID: 6507153988 Enrollment ID: I20200529001047 |
| Provider Name | Sophia T Adams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073961892 PECOS PAC ID: 2466749395 Enrollment ID: I20200529001605 |
| Provider Name | Rebecca P Bystrom |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1396277117 PECOS PAC ID: 8628341336 Enrollment ID: I20200806001497 |
| Provider Name | Wesam A. Bolkhir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407060189 PECOS PAC ID: 0042347486 Enrollment ID: I20200820000999 |
| Provider Name | Innocent A Ndzana |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306223995 PECOS PAC ID: 5799086716 Enrollment ID: I20200823000016 |
| Provider Name | Jennifer L Baldwin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1326485533 PECOS PAC ID: 6305071846 Enrollment ID: I20200902003164 |
| Provider Name | Erin M Byrt |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1497286710 PECOS PAC ID: 6204109994 Enrollment ID: I20200911000311 |
| Provider Name | Emily D Smolin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881800209 PECOS PAC ID: 6406144898 Enrollment ID: I20201130001156 |
| Provider Name | William S Jaffee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356738249 PECOS PAC ID: 7911210828 Enrollment ID: I20210204002017 |
| Provider Name | Lawrence O Harvey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376820639 PECOS PAC ID: 3971720624 Enrollment ID: I20210429002714 |
| Provider Name | Saeeda Fatima |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1023490968 PECOS PAC ID: 0840590881 Enrollment ID: I20210528001478 |
| Provider Name | Nellie D Wood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619472867 PECOS PAC ID: 2961803242 Enrollment ID: I20210623003760 |
| Provider Name | David A Lapham |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548765753 PECOS PAC ID: 1951703198 Enrollment ID: I20210712001471 |
| Provider Name | Matthew Clark |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639674591 PECOS PAC ID: 2567865504 Enrollment ID: I20210728001310 |
| Provider Name | Michael P Tozier |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1952836363 PECOS PAC ID: 9133490162 Enrollment ID: I20210804001073 |
| Provider Name | Dylan S Atchley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427547470 PECOS PAC ID: 7012256647 Enrollment ID: I20210817000707 |
| Provider Name | Jessica D Schaumburg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033641048 PECOS PAC ID: 8628473055 Enrollment ID: I20210824002112 |
| Provider Name | Isabel S Lowell |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1588976500 PECOS PAC ID: 3274773510 Enrollment ID: I20211110001736 |
| Provider Name | Avery R Osella |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104321009 PECOS PAC ID: 4981006368 Enrollment ID: I20211124002109 |
| Provider Name | Christopher G Roy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1467680884 PECOS PAC ID: 4880850197 Enrollment ID: I20211213000232 |
| Provider Name | Lindsay C Corse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639438476 PECOS PAC ID: 4385876614 Enrollment ID: I20220618000049 |
| Provider Name | Anne Kornkven |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427553353 PECOS PAC ID: 8224418868 Enrollment ID: I20220629001803 |
| Provider Name | Lauren N Boehm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083175350 PECOS PAC ID: 4880922079 Enrollment ID: I20220721000055 |
| Provider Name | Jenna S Breed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093275695 PECOS PAC ID: 5991033128 Enrollment ID: I20220811003147 |
| Provider Name | Jonathan M Nichols |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386176022 PECOS PAC ID: 0345513115 Enrollment ID: I20220817002482 |
| Provider Name | Catherine F Freeman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023570074 PECOS PAC ID: 7416283767 Enrollment ID: I20220825002756 |
| Provider Name | John K Young |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508325465 PECOS PAC ID: 8628305877 Enrollment ID: I20220913000813 |
| Provider Name | Katherine P Sharp |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649702119 PECOS PAC ID: 6406129147 Enrollment ID: I20220914003146 |
| Provider Name | Eliott Morgan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1831694447 PECOS PAC ID: 5193100857 Enrollment ID: I20220915002628 |
| Provider Name | Matthew J Cotton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801455027 PECOS PAC ID: 5799011649 Enrollment ID: I20220916000475 |
| Provider Name | William A White |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548765043 PECOS PAC ID: 7618352329 Enrollment ID: I20220916000679 |
| Provider Name | Kristen J Bartlett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255892303 PECOS PAC ID: 7113255340 Enrollment ID: I20220916001531 |
| Provider Name | Rachel Baerga Duperoy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508167628 PECOS PAC ID: 7719120237 Enrollment ID: I20220922002288 |
| Provider Name | Bhavini Prajapati |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1487159711 PECOS PAC ID: 2163899717 Enrollment ID: I20221110001790 |
| Provider Name | Elizabeth Mazzeo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1598224511 PECOS PAC ID: 4688903776 Enrollment ID: I20221110002045 |
| Provider Name | Cashel O'brien |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1093275612 PECOS PAC ID: 9830427061 Enrollment ID: I20221128001349 |
| Provider Name | Madeleine C Coleman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083103832 PECOS PAC ID: 8820343304 Enrollment ID: I20221202000881 |
| Provider Name | Elizabeth M Joyce |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710447974 PECOS PAC ID: 5991033227 Enrollment ID: I20230126001851 |
| Provider Name | Taylor Jean Roberts |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1184128878 PECOS PAC ID: 9830508738 Enrollment ID: I20230711003822 |
| Provider Name | David Yarnall Jackson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346877073 PECOS PAC ID: 3173944873 Enrollment ID: I20230814003806 |
| Provider Name | Jessica Laplante Evans |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326675455 PECOS PAC ID: 7517382286 Enrollment ID: I20230817001076 |
| Provider Name | Ross W Hilliard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033402276 PECOS PAC ID: 6305079120 Enrollment ID: I20230821000612 |
| Provider Name | Isaac Saul Lopez |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1831694785 PECOS PAC ID: 8628471638 Enrollment ID: I20230823003533 |
| Provider Name | Timothy J Bender |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1841827284 PECOS PAC ID: 6103248281 Enrollment ID: I20230828003333 |
| Provider Name | Elizabeth Clare Cummings |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1023514650 PECOS PAC ID: 8921401928 Enrollment ID: I20230905000725 |
| Provider Name | Kimberly J Toomire |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1831726421 PECOS PAC ID: 0244654291 Enrollment ID: I20230918003686 |
| Provider Name | Adam Long |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1902434798 PECOS PAC ID: 8527482611 Enrollment ID: I20230919001666 |
| Provider Name | Victoria V Molina |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1376171207 PECOS PAC ID: 9436574100 Enrollment ID: I20230919002899 |
| Provider Name | Ross Heinrich |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1386271674 PECOS PAC ID: 1951755610 Enrollment ID: I20230928002435 |
| Provider Name | Robert Gilbert Michaud |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841827987 PECOS PAC ID: 4789008871 Enrollment ID: I20231025003094 |
| Provider Name | Azhar Shah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1255837654 PECOS PAC ID: 0143609396 Enrollment ID: I20231030002808 |
| Provider Name | Rute S Rothwell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013477306 PECOS PAC ID: 0345579447 Enrollment ID: I20231204002685 |
| Provider Name | Jordan F Leonard |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558776294 PECOS PAC ID: 7113379215 Enrollment ID: I20240113000128 |
Northeast Forensic And Clinical Specialists, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11303 Gateway Ct, Scarborough, ME 04074 Phone: 347-927-5751 | |
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Infinity Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 605 Us Route 1 Ste 9, Scarborough, ME 04074 Phone: 207-347-9614 Fax: 508-546-8128 | |
Simplicity Support Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6 Track View Ter, Scarborough, ME 04074 Phone: 207-318-7916 | |
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Courtney N Wowk Lcsw Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7 Oak Hill Ter, Suite 15, Scarborough, ME 04074 Phone: 207-615-7338 |