| Allegiance Health | |
|
205 N East Ave Jackson MI 49201-1753 | |
| (517) 788-4800 | |
| Not Available |
| Full Name | Allegiance Health |
|---|---|
| Speciality | Internal Medicine |
| Location | 205 N East Ave, Jackson, Michigan |
| Authorized Official Name and Position | Jeanne' Wickens (SENIOR VICE PRESIDENT OF FINANCE) |
| Authorized Official Contact | 5177884883 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Allegiance Health Department 272801 Po Box 67000 Detroit MI 48267-2728 Ph: (517) 841-6913 | Allegiance Health 205 N East Ave Jackson MI 49201-1753 Ph: (517) 788-4800 |
| NPI Number | 1760437826 |
|---|---|
| Provider Enumeration Date | 05/24/2006 |
| Last Update Date | 09/13/2013 |
| Medicare PECOS PAC ID | 0244136067 |
|---|---|
| Medicare Enrollment ID | O20031212000691 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760437826 | NPI | - | NPPES |
| 700C810580 | Other | MI | BCBSM DOCTORS |
| CC5829 | Other | MI | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Michigan) | Primary |
| 363A00000X | Physician Assistant | (Michigan) | Secondary |
| Provider Name | David O Oladele-bankole |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083670087 PECOS PAC ID: 9335046887 Enrollment ID: I20031215000299 |
| Provider Name | Cyril Ruwende |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1376629386 PECOS PAC ID: 6507765187 Enrollment ID: I20040102000362 |
| Provider Name | Ibrahim M Aref |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1376603787 PECOS PAC ID: 7618876087 Enrollment ID: I20040105000594 |
| Provider Name | Naveed Shaikh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720039514 PECOS PAC ID: 8820999253 Enrollment ID: I20040119000003 |
| Provider Name | Munther Ajlouni |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1134297724 PECOS PAC ID: 8022902956 Enrollment ID: I20040211001015 |
| Provider Name | Deepak G Pradhan |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1720148133 PECOS PAC ID: 7416841242 Enrollment ID: I20040211001068 |
| Provider Name | Cathy Lisa Glick |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1598732539 PECOS PAC ID: 1254243983 Enrollment ID: I20040212000434 |
| Provider Name | Mark L Zande |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1639146681 PECOS PAC ID: 3678485224 Enrollment ID: I20040212000484 |
| Provider Name | Mumtaz A Memon |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1215904255 PECOS PAC ID: 5799679353 Enrollment ID: I20040212000881 |
| Provider Name | Malcolm S Trimble |
|---|---|
| Provider Type | Practitioner - Hematology |
| Provider Identifiers | NPI Number: 1831164375 PECOS PAC ID: 6002700614 Enrollment ID: I20040217000524 |
| Provider Name | Joann S Hirth |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1821063363 PECOS PAC ID: 4183518798 Enrollment ID: I20040217000955 |
| Provider Name | David P Prough |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366465528 PECOS PAC ID: 3577458595 Enrollment ID: I20040218000880 |
| Provider Name | Eric R Davies |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1982710653 PECOS PAC ID: 2567358666 Enrollment ID: I20040226000016 |
| Provider Name | Robert D Albertson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1487610481 PECOS PAC ID: 8224926795 Enrollment ID: I20040306000189 |
| Provider Name | Christine B Huff |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1003957226 PECOS PAC ID: 4587552062 Enrollment ID: I20040306000283 |
| Provider Name | James Chauncey |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1053377044 PECOS PAC ID: 3870481880 Enrollment ID: I20040310000086 |
| Provider Name | Matthew G Moore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437105640 PECOS PAC ID: 1355233545 Enrollment ID: I20040324001700 |
| Provider Name | Roger E Bloomer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235196486 PECOS PAC ID: 3274425202 Enrollment ID: I20040325001323 |
| Provider Name | Rajendra H Mehta |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770549099 PECOS PAC ID: 2860484573 Enrollment ID: I20040401001179 |
| Provider Name | Debra A Alspector |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386757375 PECOS PAC ID: 3678567534 Enrollment ID: I20040414000254 |
| Provider Name | John L Carey |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1104974815 PECOS PAC ID: 6800886953 Enrollment ID: I20040512001334 |
| Provider Name | Alicja Dorota Wasilewski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821057159 PECOS PAC ID: 8628054087 Enrollment ID: I20040625001037 |
| Provider Name | Omar Al-subee |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1194903708 PECOS PAC ID: 0143209478 Enrollment ID: I20040719001192 |
| Provider Name | William B Bivens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114029071 PECOS PAC ID: 4981675816 Enrollment ID: I20040804000738 |
| Provider Name | Ryan Andrew Beekman |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1154313336 PECOS PAC ID: 7012989700 Enrollment ID: I20040813000183 |
| Provider Name | Atsushi Yoshida |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104989730 PECOS PAC ID: 0840264198 Enrollment ID: I20040823000738 |
| Provider Name | Michele K Dodman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1659364974 PECOS PAC ID: 0345216339 Enrollment ID: I20040910000025 |
| Provider Name | Eric T Trimas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669430179 PECOS PAC ID: 3870561046 Enrollment ID: I20040924000394 |
| Provider Name | Tudor R Tien |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1033101225 PECOS PAC ID: 1759350432 Enrollment ID: I20040930000412 |
| Provider Name | Erik Sinka |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730133539 PECOS PAC ID: 3971565086 Enrollment ID: I20041101000897 |
| Provider Name | John J Wald |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1275627366 PECOS PAC ID: 6800858630 Enrollment ID: I20041103000151 |
| Provider Name | Reem J Alsabti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073548541 PECOS PAC ID: 5799741682 Enrollment ID: I20041206000231 |
| Provider Name | Melissa S Vansickle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528060266 PECOS PAC ID: 6204884224 Enrollment ID: I20050106000538 |
| Provider Name | Benjamin Movsas |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1811057227 PECOS PAC ID: 4688624901 Enrollment ID: I20050125000572 |
| Provider Name | Brian James Daly |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1790824225 PECOS PAC ID: 1850346016 Enrollment ID: I20050322000870 |
| Provider Name | Shahzad A Shaikh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598761108 PECOS PAC ID: 3870540313 Enrollment ID: I20050406000600 |
| Provider Name | Romal Bhan |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1215133228 PECOS PAC ID: 5799725933 Enrollment ID: I20050506000712 |
| Provider Name | Bruce S Barbour |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386602761 PECOS PAC ID: 3274512728 Enrollment ID: I20050526000178 |
| Provider Name | Rosemarie T Tolson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205834090 PECOS PAC ID: 5092758581 Enrollment ID: I20050606000844 |
| Provider Name | Gunjana Bhandari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518923473 PECOS PAC ID: 3375568231 Enrollment ID: I20051010000781 |
| Provider Name | Luisa Fernanda Bazan |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1891863320 PECOS PAC ID: 5092738104 Enrollment ID: I20060104000329 |
| Provider Name | Vlad Motoc |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1164462693 PECOS PAC ID: 5496715690 Enrollment ID: I20060106000375 |
| Provider Name | Jonathan P Sykes |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1689762916 PECOS PAC ID: 8123042389 Enrollment ID: I20060123000255 |
| Provider Name | Prasanth Gogineni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376641902 PECOS PAC ID: 1951315332 Enrollment ID: I20060206000810 |
| Provider Name | Mohamed Elshaikh |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1861401622 PECOS PAC ID: 0143236802 Enrollment ID: I20060306000006 |
| Provider Name | Kimberly Sue Freese Beal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275560773 PECOS PAC ID: 2466455688 Enrollment ID: I20060808000509 |
| Provider Name | John J Walper |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1942208749 PECOS PAC ID: 0244233195 Enrollment ID: I20060814000328 |
| Provider Name | Bischan Hassunizadeh |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1891705745 PECOS PAC ID: 9436153251 Enrollment ID: I20060911000343 |
| Provider Name | Carrie B Nicholson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356366819 PECOS PAC ID: 7719981539 Enrollment ID: I20060911000423 |
| Provider Name | Aruna Gollapalli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104846559 PECOS PAC ID: 0244235737 Enrollment ID: I20060915000060 |
| Provider Name | Carolyn Deann Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922042829 PECOS PAC ID: 1153327804 Enrollment ID: I20061020000050 |
| Provider Name | Alfred M Faulkner |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1326026196 PECOS PAC ID: 2567487093 Enrollment ID: I20061031000022 |
| Provider Name | Kenneth Jeffrey Levin |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1265549422 PECOS PAC ID: 3274530308 Enrollment ID: I20061101000591 |
| Provider Name | Mehdi Hassan Baluch |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1104831536 PECOS PAC ID: 0648277749 Enrollment ID: I20061102000566 |
| Provider Name | Hassan W Nemeh |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1487634044 PECOS PAC ID: 2466482682 Enrollment ID: I20061108000668 |
| Provider Name | Marshall S Grillo |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1730114448 PECOS PAC ID: 8022016799 Enrollment ID: I20061114000235 |
| Provider Name | Jon M Lake |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376561696 PECOS PAC ID: 1254242217 Enrollment ID: I20061130000131 |
| Provider Name | Tony E Pinson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1497764104 PECOS PAC ID: 2860491487 Enrollment ID: I20061208000440 |
| Provider Name | Paul J Corcoran |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1740299858 PECOS PAC ID: 1850391566 Enrollment ID: I20070103000174 |
| Provider Name | Hasan M Qutob |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1285793521 PECOS PAC ID: 7012917487 Enrollment ID: I20070109000137 |
| Provider Name | Shivakumar Reddy Deva |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750427159 PECOS PAC ID: 1658474879 Enrollment ID: I20070308000409 |
| Provider Name | Craig G Rogers |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1689602815 PECOS PAC ID: 8921021726 Enrollment ID: I20070323000092 |
| Provider Name | Kedar Vishwas Inamdar |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1093890469 PECOS PAC ID: 0648374769 Enrollment ID: I20070329000622 |
| Provider Name | Christopher Carl Pfeifer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255443438 PECOS PAC ID: 1759487192 Enrollment ID: I20070502000162 |
| Provider Name | Jayson S Greenberg |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1538197173 PECOS PAC ID: 4688773054 Enrollment ID: I20070626000365 |
| Provider Name | Brandon J Gaetino |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1396878054 PECOS PAC ID: 6800996968 Enrollment ID: I20070703000388 |
| Provider Name | Lisa L Legere-struntz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316970312 PECOS PAC ID: 0749380376 Enrollment ID: I20070712000161 |
| Provider Name | Patricia S Hoffman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538187927 PECOS PAC ID: 4082624986 Enrollment ID: I20070712000288 |
| Provider Name | Michelle Marie Reicosky Brewer |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1629282793 PECOS PAC ID: 5395845838 Enrollment ID: I20070712000353 |
| Provider Name | Bruce Bigelow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639197007 PECOS PAC ID: 0547270431 Enrollment ID: I20070713000657 |
| Provider Name | Michael A Foust |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811915218 PECOS PAC ID: 8123129053 Enrollment ID: I20070723000493 |
| Provider Name | Dhananjay A Chitale |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1659571057 PECOS PAC ID: 9537251335 Enrollment ID: I20070824000373 |
| Provider Name | Yasser Moussa Aleech |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1871698639 PECOS PAC ID: 2860396322 Enrollment ID: I20070906000068 |
| Provider Name | Mahender Macha |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1558359596 PECOS PAC ID: 8426954538 Enrollment ID: I20070914000562 |
| Provider Name | Michael Harris |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1366511560 PECOS PAC ID: 2365432671 Enrollment ID: I20070918000097 |
| Provider Name | Harish Rawal |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1396768693 PECOS PAC ID: 0143314104 Enrollment ID: I20070920000855 |
| Provider Name | Heather L Simpkins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194916601 PECOS PAC ID: 1456445329 Enrollment ID: I20070922000138 |
| Provider Name | Humphrey Atiemo |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1245293299 PECOS PAC ID: 3072558196 Enrollment ID: I20070924000019 |
| Provider Name | Anthony D Williams |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1245246354 PECOS PAC ID: 5395830699 Enrollment ID: I20071002000261 |
| Provider Name | Ahmad L Subhi |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1245437953 PECOS PAC ID: 8426144429 Enrollment ID: I20071023000139 |
| Provider Name | Nilesh S Gupta |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1235153750 PECOS PAC ID: 9931103223 Enrollment ID: I20071029000605 |
| Provider Name | Mohammad R Siddiqui |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922024751 PECOS PAC ID: 2567542848 Enrollment ID: I20071228000306 |
| Provider Name | Sunitha Govindaswamy |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1740354257 PECOS PAC ID: 6608956255 Enrollment ID: I20080108000718 |
| Provider Name | Elizabeth J Pielsticker |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1326015801 PECOS PAC ID: 0446331284 Enrollment ID: I20080117000383 |
| Provider Name | Helen M Dsa |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1346374618 PECOS PAC ID: 3476634171 Enrollment ID: I20080119000111 |
| Provider Name | Lamont R Jones |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1033235635 PECOS PAC ID: 0547339673 Enrollment ID: I20080515000481 |
| Provider Name | Bruce T Adelman |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1821083080 PECOS PAC ID: 8820040686 Enrollment ID: I20080607000110 |
| Provider Name | Vincent R Elie |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1740213115 PECOS PAC ID: 5395816896 Enrollment ID: I20080611000079 |
| Provider Name | Marc Arnkoff |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1144200270 PECOS PAC ID: 3072687581 Enrollment ID: I20080801000066 |
| Provider Name | Tamer A Ghanem |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1023185394 PECOS PAC ID: 4880792704 Enrollment ID: I20080811000087 |
| Provider Name | Hayan Jaratli |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1285898908 PECOS PAC ID: 2466528039 Enrollment ID: I20080904000595 |
| Provider Name | Shawn H Obi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275797250 PECOS PAC ID: 1355417403 Enrollment ID: I20080915000087 |
| Provider Name | Joel David Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770746943 PECOS PAC ID: 4183791296 Enrollment ID: I20080915000627 |
| Provider Name | Dimitrios Apostolou |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1851310718 PECOS PAC ID: 2668549452 Enrollment ID: I20080919000505 |
| Provider Name | Zakir H Sahul |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1083659486 PECOS PAC ID: 9537237755 Enrollment ID: I20081001000258 |
| Provider Name | Ileana Lopez Plaza |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1396727715 PECOS PAC ID: 0143292045 Enrollment ID: I20081027000793 |
| Provider Name | Tareq A Baghal |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1255332490 PECOS PAC ID: 0941296115 Enrollment ID: I20081110000747 |
| Provider Name | Michael L Wolak |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1235323981 PECOS PAC ID: 6204997786 Enrollment ID: I20081202000548 |
| Provider Name | Arthur R Gaba |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1922156637 PECOS PAC ID: 4385705664 Enrollment ID: I20081204000752 |
| Provider Name | Pauline P Chiu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093867046 PECOS PAC ID: 8224012224 Enrollment ID: I20090105000556 |
| Provider Name | Stanley John Sczecienski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780660480 PECOS PAC ID: 5890858617 Enrollment ID: I20090106000059 |
| Provider Name | Ziying Zhang |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1164631115 PECOS PAC ID: 7416013032 Enrollment ID: I20090306000147 |
| Provider Name | Mustafa Alnounou |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1235165481 PECOS PAC ID: 4284632183 Enrollment ID: I20090427000449 |
| Provider Name | William H Alarcon |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1942374558 PECOS PAC ID: 6406904598 Enrollment ID: I20090429000328 |
| Provider Name | Milagros Dalgir Samaniego-picota |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1790746154 PECOS PAC ID: 2466426986 Enrollment ID: I20090518000012 |
| Provider Name | Elena Gupta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598946782 PECOS PAC ID: 0244380731 Enrollment ID: I20090603000467 |
| Provider Name | Mohamad E El Mortada |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1215139175 PECOS PAC ID: 4183774201 Enrollment ID: I20090611000515 |
| Provider Name | Iman Sleiman Abou-chakra |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1952373078 PECOS PAC ID: 1052362415 Enrollment ID: I20090617000672 |
| Provider Name | Lawrence Narkiewicz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194950238 PECOS PAC ID: 7810048535 Enrollment ID: I20090619000146 |
| Provider Name | Nabil Sibai |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1639376304 PECOS PAC ID: 7214088665 Enrollment ID: I20090625000426 |
| Provider Name | Vishal Gupta |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1114162625 PECOS PAC ID: 2264585728 Enrollment ID: I20090730000315 |
| Provider Name | Daniel S Schultz |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1730237447 PECOS PAC ID: 9739233198 Enrollment ID: I20090819000459 |
| Provider Name | Arfaat Khan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1538379144 PECOS PAC ID: 5496800294 Enrollment ID: I20090831000475 |
| Provider Name | Erin M Diviney Chun |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1215120738 PECOS PAC ID: 4981740222 Enrollment ID: I20090930000277 |
| Provider Name | Lynn C Vanwagnen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609833359 PECOS PAC ID: 0244136075 Enrollment ID: I20091013000163 |
| Provider Name | Nessrine Ktaich |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1952535049 PECOS PAC ID: 1355488552 Enrollment ID: I20091020000706 |
| Provider Name | Naveen Reddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134292154 PECOS PAC ID: 8729129135 Enrollment ID: I20100107000460 |
| Provider Name | Frank Lamarca |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1548367808 PECOS PAC ID: 1052452083 Enrollment ID: I20100112000721 |
| Provider Name | Anita Patel |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1144398694 PECOS PAC ID: 6901940436 Enrollment ID: I20100222000139 |
| Provider Name | Marsha L Chaffins |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1184702219 PECOS PAC ID: 8729122239 Enrollment ID: I20100222000910 |
| Provider Name | Timothy Shinn |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1013984566 PECOS PAC ID: 2365529054 Enrollment ID: I20100325000752 |
| Provider Name | Dilip K Moonka |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1982772430 PECOS PAC ID: 8527195577 Enrollment ID: I20100422000484 |
| Provider Name | Kimberly A Brown |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1508934035 PECOS PAC ID: 6608904016 Enrollment ID: I20100505000807 |
| Provider Name | David Burks |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1033279906 PECOS PAC ID: 8224167234 Enrollment ID: I20100601000788 |
| Provider Name | Craig D Silverton |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1114093580 PECOS PAC ID: 9830228840 Enrollment ID: I20100601000811 |
| Provider Name | Mohan G Kulkarni |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1790725158 PECOS PAC ID: 5496819609 Enrollment ID: I20100603000728 |
| Provider Name | Jeffrey A Genaw |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1881725679 PECOS PAC ID: 9335279173 Enrollment ID: I20100604000950 |
| Provider Name | James O Peabody |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1396805164 PECOS PAC ID: 9436289113 Enrollment ID: I20100607000101 |
| Provider Name | Paul A Edwards |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1659431054 PECOS PAC ID: 9739219122 Enrollment ID: I20100610001040 |
| Provider Name | Donard G Haggins |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1922176460 PECOS PAC ID: 6507996436 Enrollment ID: I20100618000743 |
| Provider Name | Annette Elizabeth Kretzler |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1942328414 PECOS PAC ID: 2769514132 Enrollment ID: I20100720001060 |
| Provider Name | Neil Chase Caliman |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1316041692 PECOS PAC ID: 0648270132 Enrollment ID: I20100721000081 |
| Provider Name | Jadranka Dragovic |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1093875403 PECOS PAC ID: 4789716895 Enrollment ID: I20100723000945 |
| Provider Name | Michael Boros |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1942403159 PECOS PAC ID: 0345373452 Enrollment ID: I20100726000848 |
| Provider Name | David Lee Halsey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457319832 PECOS PAC ID: 4486550217 Enrollment ID: I20100728000748 |
| Provider Name | Helene Monica Fligiel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023270881 PECOS PAC ID: 9133253123 Enrollment ID: I20100812000501 |
| Provider Name | Thomas P Hessburg |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1730249137 PECOS PAC ID: 6406980317 Enrollment ID: I20100813000936 |
| Provider Name | Jashu R Patel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1366408692 PECOS PAC ID: 3274502273 Enrollment ID: I20100813001058 |
| Provider Name | Frank Solf |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1548294689 PECOS PAC ID: 8123175353 Enrollment ID: I20100820000939 |
| Provider Name | Loay S Kabbani |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1073578407 PECOS PAC ID: 9638220411 Enrollment ID: I20100825000743 |
| Provider Name | Bianca B Ferrari |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1386850832 PECOS PAC ID: 1355465881 Enrollment ID: I20100903000738 |
| Provider Name | Ilaaf Darrat |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1205047453 PECOS PAC ID: 5395860118 Enrollment ID: I20100917000079 |
| Provider Name | Syed Raza |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1063636306 PECOS PAC ID: 8224220165 Enrollment ID: I20101011000099 |
| Provider Name | Nitin R Ambani |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1417966060 PECOS PAC ID: 9537269923 Enrollment ID: I20101012000113 |
| Provider Name | Talal T M Khader |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033314513 PECOS PAC ID: 2668665068 Enrollment ID: I20101018001177 |
| Provider Name | Brian Arthur Adamczyk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205856390 PECOS PAC ID: 7911190343 Enrollment ID: I20101019000129 |
| Provider Name | Stephen L Kirkner |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1922097492 PECOS PAC ID: 8921091208 Enrollment ID: I20101029000688 |
| Provider Name | Imdad H Butt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548210487 PECOS PAC ID: 1557555810 Enrollment ID: I20101101000042 |
| Provider Name | Lesley L Combs |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1285844191 PECOS PAC ID: 1951595271 Enrollment ID: I20101101000706 |
| Provider Name | Shigang Liu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1144272048 PECOS PAC ID: 3274728019 Enrollment ID: I20101105001334 |
| Provider Name | Rocky Edward Pittman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881884997 PECOS PAC ID: 3870788482 Enrollment ID: I20101109000854 |
| Provider Name | Syed-mohammed R Jafri |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1801027644 PECOS PAC ID: 7810958154 Enrollment ID: I20101109001242 |
| Provider Name | Rubina Kausar Shaikh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659524429 PECOS PAC ID: 3779778253 Enrollment ID: I20101110000228 |
| Provider Name | Ravnita Sharma-roberts |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1659699189 PECOS PAC ID: 9537354626 Enrollment ID: I20101115001112 |
| Provider Name | Elias Hazzi |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1164418042 PECOS PAC ID: 5698663813 Enrollment ID: I20101213000473 |
| Provider Name | Shana Ageloff-kupetz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437385382 PECOS PAC ID: 9638200538 Enrollment ID: I20110111000754 |
| Provider Name | Wassim Noureddine |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548421167 PECOS PAC ID: 7113094905 Enrollment ID: I20110209000831 |
| Provider Name | Vinh Nguyen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316140924 PECOS PAC ID: 2769662410 Enrollment ID: I20110211000835 |
| Provider Name | Wanda B Iza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033147699 PECOS PAC ID: 0941260277 Enrollment ID: I20110218000840 |
| Provider Name | Sylvia Anagnos |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1255428967 PECOS PAC ID: 9931199056 Enrollment ID: I20110218001019 |
| Provider Name | Kristina Lynn Sturgill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720249667 PECOS PAC ID: 2264616010 Enrollment ID: I20110404000170 |
| Provider Name | Syed T Ahmed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326097627 PECOS PAC ID: 0547270100 Enrollment ID: I20110427000729 |
| Provider Name | Anish Wadhwa |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1235348400 PECOS PAC ID: 2062569155 Enrollment ID: I20110502000259 |
| Provider Name | Nathan A Mann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811155112 PECOS PAC ID: 8325190671 Enrollment ID: I20110629000519 |
| Provider Name | Rami A Alzebdeh |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1497954598 PECOS PAC ID: 2668650979 Enrollment ID: I20110708000341 |
| Provider Name | Fadi Alali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104073022 PECOS PAC ID: 4284802299 Enrollment ID: I20110719000099 |
| Provider Name | Hussein Othman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1306089040 PECOS PAC ID: 3678741162 Enrollment ID: I20110728000292 |
| Provider Name | Sattar Abdus Sheikh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023079209 PECOS PAC ID: 3375713670 Enrollment ID: I20110824000169 |
| Provider Name | Harpreet Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831331719 PECOS PAC ID: 3678743846 Enrollment ID: I20110825000231 |
| Provider Name | John Winestone |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1598933301 PECOS PAC ID: 0446420640 Enrollment ID: I20110825000565 |
| Provider Name | Vessela Giger-mateeva |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487896254 PECOS PAC ID: 4789855776 Enrollment ID: I20110923000201 |
| Provider Name | Vivian Faye Wu |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1881849115 PECOS PAC ID: 0840461604 Enrollment ID: I20110927000754 |
| Provider Name | Bipin Ravindran |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1649387945 PECOS PAC ID: 9032291539 Enrollment ID: I20110930000134 |
| Provider Name | Laszlo Marco Hoesel |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1447452057 PECOS PAC ID: 4385816735 Enrollment ID: I20111007000558 |
| Provider Name | Padmaja Manne |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669629507 PECOS PAC ID: 0143492389 Enrollment ID: I20111011000580 |
| Provider Name | Rupali Abhijit Paradkar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215172713 PECOS PAC ID: 9436296951 Enrollment ID: I20111205000067 |
| Provider Name | Patricia Strimpel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801021860 PECOS PAC ID: 8426215740 Enrollment ID: I20120128000023 |
| Provider Name | Christian Keller |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1386868495 PECOS PAC ID: 5597855106 Enrollment ID: I20120221000736 |
| Provider Name | Edin Basic |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1124206685 PECOS PAC ID: 2668633678 Enrollment ID: I20120419000225 |
| Provider Name | Farzan Siddiqui |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1922217793 PECOS PAC ID: 4486779626 Enrollment ID: I20120420000587 |
| Provider Name | Danial Rashid |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407098882 PECOS PAC ID: 9537323803 Enrollment ID: I20120618000372 |
| Provider Name | Gaurav Sharma |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1083823850 PECOS PAC ID: 1254596083 Enrollment ID: I20120629000245 |
| Provider Name | Sameer Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972725083 PECOS PAC ID: 6406921311 Enrollment ID: I20120709000504 |
| Provider Name | M Salim U Siddiqui |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1396010922 PECOS PAC ID: 9436315462 Enrollment ID: I20120719000358 |
| Provider Name | Brittany Williamson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184852980 PECOS PAC ID: 3072769157 Enrollment ID: I20120806000091 |
| Provider Name | Sonalee Shah |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1245498708 PECOS PAC ID: 1254587231 Enrollment ID: I20120807000377 |
| Provider Name | Andrew M Duda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962738575 PECOS PAC ID: 9931355682 Enrollment ID: I20120810000817 |
| Provider Name | Veera Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770782971 PECOS PAC ID: 2163599952 Enrollment ID: I20120824000856 |
| Provider Name | Pritika Shrivastava |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508067786 PECOS PAC ID: 4587725841 Enrollment ID: I20121012000322 |
| Provider Name | Tarek Saleh |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1790915544 PECOS PAC ID: 5597915959 Enrollment ID: I20121019000205 |
| Provider Name | Chidamber Alamelumangapuram |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992956122 PECOS PAC ID: 3678725421 Enrollment ID: I20121130000536 |
| Provider Name | Sergio A Montoya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073789301 PECOS PAC ID: 7012169469 Enrollment ID: I20130131000164 |
| Provider Name | Timothy E Ekpo |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1891003240 PECOS PAC ID: 9436305984 Enrollment ID: I20130205000447 |
| Provider Name | Binu Malhotra |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1104023118 PECOS PAC ID: 3173615457 Enrollment ID: I20130306000457 |
| Provider Name | Jordan P Knepper |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1760610885 PECOS PAC ID: 5991950396 Enrollment ID: I20130312000007 |
| Provider Name | Wooju Jeong |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1851626774 PECOS PAC ID: 4688819956 Enrollment ID: I20130315000104 |
| Provider Name | Kristoffer Bradley Sugg |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1104029693 PECOS PAC ID: 7810138591 Enrollment ID: I20130723000057 |
| Provider Name | Syed Haris Tasleem |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689803678 PECOS PAC ID: 1355591082 Enrollment ID: I20130729000458 |
| Provider Name | Sean Williamson |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1386805489 PECOS PAC ID: 9537303219 Enrollment ID: I20130919000144 |
| Provider Name | Carey S Hill |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821017161 PECOS PAC ID: 0840376224 Enrollment ID: I20130924000482 |
| Provider Name | Joseph A Sanders |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1619138153 PECOS PAC ID: 5890943310 Enrollment ID: I20131009000216 |
| Provider Name | Robert H Deeb |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1114123445 PECOS PAC ID: 8729235338 Enrollment ID: I20131030001058 |
| Provider Name | Srijana P Bakshi |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1972764520 PECOS PAC ID: 9234364100 Enrollment ID: I20131030001584 |
| Provider Name | Reena J Salgia |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1528180601 PECOS PAC ID: 5193950889 Enrollment ID: I20131105001875 |
| Provider Name | Tiberio M Frisoli |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1609178581 PECOS PAC ID: 8123254117 Enrollment ID: I20131121001169 |
| Provider Name | Suman Preet Kaur Bhullar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538473988 PECOS PAC ID: 5395971329 Enrollment ID: I20131122000665 |
| Provider Name | Mark Thompson |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1427043454 PECOS PAC ID: 6204875669 Enrollment ID: I20140103001009 |
| Provider Name | Gregory James Cerilli |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1194720284 PECOS PAC ID: 6305824665 Enrollment ID: I20140122001774 |
| Provider Name | Amy R Spencer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1043489842 PECOS PAC ID: 7113155953 Enrollment ID: I20140124000457 |
| Provider Name | Jonathan E Schweid |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1891991931 PECOS PAC ID: 4789726696 Enrollment ID: I20140204001512 |
| Provider Name | Faisal Mohuddin Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104139401 PECOS PAC ID: 5092944207 Enrollment ID: I20140211001459 |
| Provider Name | Sonia A Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710299961 PECOS PAC ID: 5991934044 Enrollment ID: I20140212001238 |
| Provider Name | Terry A Ellis |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1699843540 PECOS PAC ID: 2264691450 Enrollment ID: I20140409002455 |
| Provider Name | Dresden H P Beier |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1366707531 PECOS PAC ID: 5193957769 Enrollment ID: I20140414000635 |
| Provider Name | Mohammad Sameer Zaheerullah |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1295978526 PECOS PAC ID: 5597905562 Enrollment ID: I20140428000849 |
| Provider Name | Michael F Martone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306145578 PECOS PAC ID: 7113170283 Enrollment ID: I20140506000802 |
| Provider Name | Wassim M Bazzi |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1316106537 PECOS PAC ID: 2466694237 Enrollment ID: I20140514000260 |
| Provider Name | Fadi H Delly |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104137967 PECOS PAC ID: 4183847767 Enrollment ID: I20140529001178 |
| Provider Name | Altin Miraka |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1518133792 PECOS PAC ID: 3173747391 Enrollment ID: I20140610000325 |
| Provider Name | Qinghui Liu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750519559 PECOS PAC ID: 6305060468 Enrollment ID: I20140610002103 |
| Provider Name | Usman S Khokhar |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1265639520 PECOS PAC ID: 8325262678 Enrollment ID: I20140611001245 |
| Provider Name | Matthew R Jonovich |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1548378540 PECOS PAC ID: 0749331163 Enrollment ID: I20140617001831 |
| Provider Name | Richard Walter Seeger |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1790713220 PECOS PAC ID: 7517040967 Enrollment ID: I20140709002560 |
| Provider Name | Michael Isley |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1740227818 PECOS PAC ID: 3173422656 Enrollment ID: I20140724001228 |
| Provider Name | Karen J Enright |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1588647937 PECOS PAC ID: 9436223815 Enrollment ID: I20140725000633 |
| Provider Name | Syed Ali Rizvi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1740575216 PECOS PAC ID: 7517199037 Enrollment ID: I20140731001798 |
| Provider Name | Moiz Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174803357 PECOS PAC ID: 8123245792 Enrollment ID: I20140806000922 |
| Provider Name | Samvid A Dwivedi |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1306071824 PECOS PAC ID: 2163654153 Enrollment ID: I20140822000481 |
| Provider Name | Ganesh C Kudva |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1689682551 PECOS PAC ID: 6406806215 Enrollment ID: I20141125001972 |
| Provider Name | Haitham Mukhtar Al-okk |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1891891180 PECOS PAC ID: 7113997735 Enrollment ID: I20150116001055 |
| Provider Name | Anandeep Kumar |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1205814860 PECOS PAC ID: 0648314989 Enrollment ID: I20150123000833 |
| Provider Name | Randy K Bell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952573602 PECOS PAC ID: 7214106152 Enrollment ID: I20150211002198 |
| Provider Name | Nicole Piscatelli |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1437206562 PECOS PAC ID: 0042495145 Enrollment ID: I20150311001252 |
| Provider Name | Abbas Zagnoon |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1033313028 PECOS PAC ID: 7315073707 Enrollment ID: I20150416000301 |
| Provider Name | Hesham M Ahmed |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1104015056 PECOS PAC ID: 6406915362 Enrollment ID: I20150505001952 |
| Provider Name | Dongwoo John Chang |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1962485037 PECOS PAC ID: 6709779853 Enrollment ID: I20150521002090 |
| Provider Name | Abdullah Adnan |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1578855847 PECOS PAC ID: 9537480272 Enrollment ID: I20150605000989 |
| Provider Name | Samih K Mawari |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1851520910 PECOS PAC ID: 5496925786 Enrollment ID: I20150605002272 |
| Provider Name | Rohini Prashar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023248598 PECOS PAC ID: 7315268836 Enrollment ID: I20150609000435 |
| Provider Name | Sukhpreet K Singh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336401124 PECOS PAC ID: 3678706645 Enrollment ID: I20150615000336 |
| Provider Name | Paul Abrams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619264280 PECOS PAC ID: 8729238381 Enrollment ID: I20150714000108 |
| Provider Name | Ghassen Allo |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1265835110 PECOS PAC ID: 1052624160 Enrollment ID: I20150720000403 |
| Provider Name | Michelle Aubin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1073773156 PECOS PAC ID: 5991018814 Enrollment ID: I20150722003799 |
| Provider Name | Ahmad A Itani |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1386933059 PECOS PAC ID: 8224251376 Enrollment ID: I20150722006339 |
| Provider Name | Mira M Shah |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1740506351 PECOS PAC ID: 5294967311 Enrollment ID: I20150729009102 |
| Provider Name | Joshua E Yankelove |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1659683886 PECOS PAC ID: 7315251634 Enrollment ID: I20150730013210 |
| Provider Name | John Robert Craig |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1770717456 PECOS PAC ID: 4981828423 Enrollment ID: I20150803001517 |
| Provider Name | Ross Michael Mayerhoff |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1033446547 PECOS PAC ID: 8729207972 Enrollment ID: I20150803001708 |
| Provider Name | Mir B Basir |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1326369695 PECOS PAC ID: 2062652134 Enrollment ID: I20150909000687 |
| Provider Name | Vidya Challapalli |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1346299419 PECOS PAC ID: 4183613706 Enrollment ID: I20150914002191 |
| Provider Name | Ashraf Abou El Ela |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1609149632 PECOS PAC ID: 1759549504 Enrollment ID: I20150921000294 |
| Provider Name | Jill L Gorsuch |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1851523377 PECOS PAC ID: 9830314426 Enrollment ID: I20150922002695 |
| Provider Name | Michael C Lewis |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1780616862 PECOS PAC ID: 3375505829 Enrollment ID: I20151005002543 |
| Provider Name | Dafina Wise Allen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811288400 PECOS PAC ID: 7911128186 Enrollment ID: I20151021000363 |
| Provider Name | Nicholas S. Yeldo |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1801129218 PECOS PAC ID: 9436468998 Enrollment ID: I20151023000020 |
| Provider Name | William T Peruzzi |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1255370441 PECOS PAC ID: 6305859737 Enrollment ID: I20151102002012 |
| Provider Name | Abdul Kareem Sharaf |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720344880 PECOS PAC ID: 5395045173 Enrollment ID: I20151201000133 |
| Provider Name | Anamaria B Bondici |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1942524020 PECOS PAC ID: 8729237086 Enrollment ID: I20160113000575 |
| Provider Name | Ziaullah Virk |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1740267533 PECOS PAC ID: 3476523861 Enrollment ID: I20160119000384 |
| Provider Name | Patrick B Forrest |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1518259282 PECOS PAC ID: 4587968656 Enrollment ID: I20160210001281 |
| Provider Name | Gary E Loyd |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1275592974 PECOS PAC ID: 5193783843 Enrollment ID: I20160211000966 |
| Provider Name | David L Moore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346503349 PECOS PAC ID: 1658526892 Enrollment ID: I20160217000381 |
| Provider Name | Puraj Pravinchandra Patel |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1295049286 PECOS PAC ID: 6800101197 Enrollment ID: I20160218002329 |
| Provider Name | Syed S Qadri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619233749 PECOS PAC ID: 1355648692 Enrollment ID: I20160331000390 |
| Provider Name | Avtar Singh Dhindsa |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1790844181 PECOS PAC ID: 7618079492 Enrollment ID: I20160404000596 |
| Provider Name | Brian J Cousino |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1962775122 PECOS PAC ID: 1759689169 Enrollment ID: I20160419001758 |
| Provider Name | Ahmad M Yasin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598007510 PECOS PAC ID: 4587973318 Enrollment ID: I20160428000992 |
| Provider Name | Adrian Mzee Smith |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1538375076 PECOS PAC ID: 1153558440 Enrollment ID: I20160502000463 |
| Provider Name | Bertha Parthenia Richardson |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1184674707 PECOS PAC ID: 0547243487 Enrollment ID: I20160518002469 |
| Provider Name | Leonard Esward Philo |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1396893699 PECOS PAC ID: 5193016194 Enrollment ID: I20160622001764 |
| Provider Name | Michael B Shannon |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1043210727 PECOS PAC ID: 9739334657 Enrollment ID: I20160628000555 |
| Provider Name | Deepak Venkat |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1013133412 PECOS PAC ID: 9133272537 Enrollment ID: I20160628000840 |
| Provider Name | Zafar Zamir |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1336123058 PECOS PAC ID: 7113930264 Enrollment ID: I20160715000853 |
| Provider Name | Valerie L Howell |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1578839569 PECOS PAC ID: 6305078072 Enrollment ID: I20160718001168 |
| Provider Name | Aditi Saxena |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1972766574 PECOS PAC ID: 7618197112 Enrollment ID: I20160725000290 |
| Provider Name | Keleigh A Muxlow |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1730528001 PECOS PAC ID: 3577856616 Enrollment ID: I20160726003244 |
| Provider Name | Syed H Jaffery |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1699724112 PECOS PAC ID: 8022080191 Enrollment ID: I20160727002258 |
| Provider Name | Bharath Sunkara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366797797 PECOS PAC ID: 7113228982 Enrollment ID: I20160729000884 |
| Provider Name | Syed Kamel Nasser |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720228083 PECOS PAC ID: 5193873719 Enrollment ID: I20160729000892 |
| Provider Name | Imran Hayat Tarrar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639510662 PECOS PAC ID: 4880987759 Enrollment ID: I20160729001663 |
| Provider Name | Juan C Gomez-gelvez |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1558636126 PECOS PAC ID: 2961635164 Enrollment ID: I20160802001095 |
| Provider Name | Courtland Keteyian |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1821382235 PECOS PAC ID: 5991099590 Enrollment ID: I20160804000909 |
| Provider Name | Hussam Sabbagh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326452509 PECOS PAC ID: 7214239292 Enrollment ID: I20160817000659 |
| Provider Name | Candice K Gates |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205191202 PECOS PAC ID: 7416242003 Enrollment ID: I20160822001246 |
| Provider Name | Kelly M Cannon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992160451 PECOS PAC ID: 5597051656 Enrollment ID: I20160915002190 |
| Provider Name | Jay P Babich |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275862732 PECOS PAC ID: 3870626203 Enrollment ID: I20160915002670 |
| Provider Name | Mun Y Choe |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1194087106 PECOS PAC ID: 6305078395 Enrollment ID: I20160923000593 |
| Provider Name | Kathleen Viola |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1083971436 PECOS PAC ID: 0143512848 Enrollment ID: I20161004001204 |
| Provider Name | Raed M Alnajjar |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1215107982 PECOS PAC ID: 8527207869 Enrollment ID: I20161005000054 |
| Provider Name | Scott A Shelton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134565682 PECOS PAC ID: 5890939342 Enrollment ID: I20161005002724 |
| Provider Name | Elizabeth Campbell Assenmacher |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1609169507 PECOS PAC ID: 2466740147 Enrollment ID: I20161012001755 |
| Provider Name | Ali Amin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770833147 PECOS PAC ID: 1850527920 Enrollment ID: I20161012001835 |
| Provider Name | Janakkumar P Kansagra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699076596 PECOS PAC ID: 3678861903 Enrollment ID: I20161019001267 |
| Provider Name | Michael A Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124406186 PECOS PAC ID: 2567774045 Enrollment ID: I20161020000530 |
| Provider Name | Rachel Pughsley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1841602919 PECOS PAC ID: 5092930339 Enrollment ID: I20161024002447 |
| Provider Name | David E Boger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669810842 PECOS PAC ID: 1658509104 Enrollment ID: I20161031000099 |
| Provider Name | Gwen Choi |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1528287836 PECOS PAC ID: 2961579115 Enrollment ID: I20161031000206 |
| Provider Name | Ihab Hammoud |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1538378617 PECOS PAC ID: 0749475549 Enrollment ID: I20161031001778 |
| Provider Name | Kannan Suri Mohanram |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1285186544 PECOS PAC ID: 1850670027 Enrollment ID: I20161110000648 |
| Provider Name | Kai Denski |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104138841 PECOS PAC ID: 2466679923 Enrollment ID: I20161212000752 |
| Provider Name | Tahira F Mirza |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1063690691 PECOS PAC ID: 2668558313 Enrollment ID: I20170110000259 |
| Provider Name | Usama Assaad |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1497097174 PECOS PAC ID: 7416267760 Enrollment ID: I20170130001163 |
| Provider Name | Jason Louis Roby |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295981512 PECOS PAC ID: 2163735291 Enrollment ID: I20170220002887 |
| Provider Name | Bradley S Huizenga |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982040598 PECOS PAC ID: 8426287228 Enrollment ID: I20170306001200 |
| Provider Name | Mohammed Najeeb Al Hallak |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1205088556 PECOS PAC ID: 8628247871 Enrollment ID: I20170418000699 |
| Provider Name | Sairia Dass |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831537265 PECOS PAC ID: 1153547708 Enrollment ID: I20170508000444 |
| Provider Name | Adnan Aldurah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811302227 PECOS PAC ID: 9638466980 Enrollment ID: I20170517000953 |
| Provider Name | Rafid Asfar |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1639468747 PECOS PAC ID: 2961626486 Enrollment ID: I20170523001348 |
| Provider Name | Azam Basheer |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1598076739 PECOS PAC ID: 3870725583 Enrollment ID: I20170525001284 |
| Provider Name | Margaret Coplin |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1093743551 PECOS PAC ID: 4587636873 Enrollment ID: I20170530002534 |
| Provider Name | Kyle David Perry |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1003053901 PECOS PAC ID: 9739235532 Enrollment ID: I20170607000931 |
| Provider Name | Mirza Uddin Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538697248 PECOS PAC ID: 3375811334 Enrollment ID: I20170615000474 |
| Provider Name | Andrew Girgis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194253807 PECOS PAC ID: 7719255785 Enrollment ID: I20170615000559 |
| Provider Name | Richard Albert Santos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104849025 PECOS PAC ID: 8325071723 Enrollment ID: I20170622000958 |
| Provider Name | Matthew Dellaquila |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1205152725 PECOS PAC ID: 0749406692 Enrollment ID: I20170626001793 |
| Provider Name | Nadeen Khoury |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922396548 PECOS PAC ID: 3274772884 Enrollment ID: I20170628002458 |
| Provider Name | Wamidh L Alkhoory |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1437415122 PECOS PAC ID: 2961635479 Enrollment ID: I20170628002676 |
| Provider Name | Ben J Friedman |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1477813855 PECOS PAC ID: 6406088921 Enrollment ID: I20170629002449 |
| Provider Name | Shoshana Woo Ambani |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1316175433 PECOS PAC ID: 9133436868 Enrollment ID: I20170710001276 |
| Provider Name | Maria C Opolka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467863365 PECOS PAC ID: 0244455475 Enrollment ID: I20170717000383 |
| Provider Name | Adnan Hussain |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1730591066 PECOS PAC ID: 9234448317 Enrollment ID: I20170721000374 |
| Provider Name | Zhiqiang Wang |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1275788705 PECOS PAC ID: 8729277892 Enrollment ID: I20170721002821 |
| Provider Name | Mary Louise Jarzebowski |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1770847196 PECOS PAC ID: 0941509913 Enrollment ID: I20170731002599 |
| Provider Name | Sean M Vance |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1336415272 PECOS PAC ID: 9335372481 Enrollment ID: I20170808000815 |
| Provider Name | Amanpreet K Bhullar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255749735 PECOS PAC ID: 9436453347 Enrollment ID: I20170816003005 |
| Provider Name | Suhael R Momin |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1861783581 PECOS PAC ID: 6406140037 Enrollment ID: I20170821002070 |
| Provider Name | Shamik N Dwivedi |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1952667081 PECOS PAC ID: 0941423479 Enrollment ID: I20170929002689 |
| Provider Name | Michael Stephen Somero |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1083690796 PECOS PAC ID: 0941369417 Enrollment ID: I20171010001819 |
| Provider Name | Muhammad Ahmad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184016073 PECOS PAC ID: 4284919655 Enrollment ID: I20171221000045 |
| Provider Name | Abir L Mukherjee |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1770738296 PECOS PAC ID: 1052506854 Enrollment ID: I20180213002537 |
| Provider Name | Mohamed Rezik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467792143 PECOS PAC ID: 8123259306 Enrollment ID: I20180306001575 |
| Provider Name | Newton J Hurst |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1417248170 PECOS PAC ID: 3971807348 Enrollment ID: I20180501001723 |
| Provider Name | Fahad Shahjahan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558781450 PECOS PAC ID: 7113229436 Enrollment ID: I20180510000185 |
| Provider Name | David A Gessert |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750709465 PECOS PAC ID: 2668697681 Enrollment ID: I20180523001049 |
| Provider Name | Devin B Malik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568722981 PECOS PAC ID: 9335370899 Enrollment ID: I20180611000866 |
| Provider Name | Humberto C Gonzalez Gonzalez |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1043401086 PECOS PAC ID: 6608000575 Enrollment ID: I20180611002904 |
| Provider Name | Amanda Chivu Brannick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467847673 PECOS PAC ID: 4082910401 Enrollment ID: I20180619001299 |
| Provider Name | Justin Rutt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578950804 PECOS PAC ID: 3678829967 Enrollment ID: I20180628001363 |
| Provider Name | Kalen J Rimar |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1003179730 PECOS PAC ID: 0143503920 Enrollment ID: I20180703002401 |
| Provider Name | Brian Scott Lapinski |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1154761567 PECOS PAC ID: 4486974698 Enrollment ID: I20180707000149 |
| Provider Name | Laura R Garcia Rodriguez |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1508125063 PECOS PAC ID: 9335371889 Enrollment ID: I20180716001597 |
| Provider Name | Ketan Chopra |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1730574534 PECOS PAC ID: 5092013805 Enrollment ID: I20180726002526 |
| Provider Name | Eiran Avraham Warner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205193570 PECOS PAC ID: 1456609692 Enrollment ID: I20180806000896 |
| Provider Name | Zeena Husain |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1366738213 PECOS PAC ID: 6305124587 Enrollment ID: I20180817003190 |
| Provider Name | Jie Yan |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1427413954 PECOS PAC ID: 2264720994 Enrollment ID: I20180822003365 |
| Provider Name | Hue C Thai |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1730333071 PECOS PAC ID: 2860701752 Enrollment ID: I20180911000274 |
| Provider Name | Jessica Renee Was |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1255565859 PECOS PAC ID: 7113169830 Enrollment ID: I20180925002059 |
| Provider Name | Oudai Hassan |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1760732143 PECOS PAC ID: 9830482322 Enrollment ID: I20181002001292 |
| Provider Name | Kristen Horner Angster |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1003115759 PECOS PAC ID: 1759670706 Enrollment ID: I20181106002258 |
| Provider Name | Brian P Denton |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1669815098 PECOS PAC ID: 4082986260 Enrollment ID: I20181112001976 |
| Provider Name | Allison J Brown |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1366647562 PECOS PAC ID: 4880863984 Enrollment ID: I20181113001004 |
| Provider Name | Adam Jon Rubinstein |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1508808338 PECOS PAC ID: 2466444286 Enrollment ID: I20181129000184 |
| Provider Name | Parag J Parikh |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1528088929 PECOS PAC ID: 6204832744 Enrollment ID: I20181201000283 |
| Provider Name | Saida Rafaelovna Saidova |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1275860678 PECOS PAC ID: 4284970666 Enrollment ID: I20190104002556 |
| Provider Name | Diana Marie Flis |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1972890085 PECOS PAC ID: 5597067884 Enrollment ID: I20190221001708 |
| Provider Name | Laura A Favazza |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1336482934 PECOS PAC ID: 8123250529 Enrollment ID: I20190315001414 |
| Provider Name | Sanam Husain |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1689715807 PECOS PAC ID: 5294868519 Enrollment ID: I20190327001606 |
| Provider Name | Merritt Jonathan Bern |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1720066483 PECOS PAC ID: 9032205141 Enrollment ID: I20190502000490 |
| Provider Name | Abdul K Uduman |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1487920740 PECOS PAC ID: 3678706819 Enrollment ID: I20190522000057 |
| Provider Name | Blake Andrew Brannick |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1164873527 PECOS PAC ID: 6800139106 Enrollment ID: I20190529001604 |
| Provider Name | Daniela Memoli |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1659787232 PECOS PAC ID: 3577780543 Enrollment ID: I20190626001694 |
| Provider Name | Soumaya Ezwawi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881045847 PECOS PAC ID: 4082998844 Enrollment ID: I20190703002439 |
| Provider Name | Jovica Veljanovski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295143600 PECOS PAC ID: 6406074079 Enrollment ID: I20190710002880 |
| Provider Name | Sylvester Paulasir |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1689932998 PECOS PAC ID: 8022267905 Enrollment ID: I20190717001385 |
| Provider Name | Deane Franso |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1407122906 PECOS PAC ID: 5395071906 Enrollment ID: I20190719000673 |
| Provider Name | Pedro Arturo Villablanca Spinetto |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1518254630 PECOS PAC ID: 2365778891 Enrollment ID: I20190722002824 |
| Provider Name | Mark S Morris |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1578901526 PECOS PAC ID: 9830327147 Enrollment ID: I20190726002839 |
| Provider Name | Alpa Garg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750658084 PECOS PAC ID: 0143531467 Enrollment ID: I20190729000191 |
| Provider Name | Andrew Noah Prussack |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1629458559 PECOS PAC ID: 9830406362 Enrollment ID: I20190808002332 |
| Provider Name | Eric C Haynes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972954220 PECOS PAC ID: 6406141258 Enrollment ID: I20190812001601 |
| Provider Name | Yulei Shen |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1710329206 PECOS PAC ID: 0547532491 Enrollment ID: I20190826002638 |
| Provider Name | Nicole Horning |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1215317235 PECOS PAC ID: 5698082170 Enrollment ID: I20190923002524 |
| Provider Name | Melinda Mitchell |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1093195018 PECOS PAC ID: 8325357429 Enrollment ID: I20191002002392 |
| Provider Name | Joseph Montecalvo |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1114263290 PECOS PAC ID: 9436406410 Enrollment ID: I20191008002434 |
| Provider Name | Hamsa Khalil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427409788 PECOS PAC ID: 2062707813 Enrollment ID: I20191014001816 |
| Provider Name | Hazem Yousef Zebda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528447968 PECOS PAC ID: 1254643950 Enrollment ID: I20191017000448 |
| Provider Name | Britiany Sheard-caple |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1891107926 PECOS PAC ID: 8921315284 Enrollment ID: I20191030001845 |
| Provider Name | Joseph L Medellin |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1487073433 PECOS PAC ID: 8426321829 Enrollment ID: I20191105001936 |
| Provider Name | Khatib Jafri |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1811970932 PECOS PAC ID: 8123018173 Enrollment ID: I20191122002123 |
| Provider Name | David A. Kolde |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407852403 PECOS PAC ID: 9931239266 Enrollment ID: I20191126002011 |
| Provider Name | Rovin Saxena |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184076952 PECOS PAC ID: 8729365473 Enrollment ID: I20200211002765 |
| Provider Name | Rachel Campbell Hooper |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1750524534 PECOS PAC ID: 1355637430 Enrollment ID: I20200307000105 |
| Provider Name | Bara Zuhaili |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1396994851 PECOS PAC ID: 5890939011 Enrollment ID: I20200313000536 |
| Provider Name | Rohit Kakar |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1992069462 PECOS PAC ID: 2365743796 Enrollment ID: I20200316000493 |
| Provider Name | Joshua Romero |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1033478813 PECOS PAC ID: 6800224064 Enrollment ID: I20200322000146 |
| Provider Name | Lisi Yuan |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1306266978 PECOS PAC ID: 3375971492 Enrollment ID: I20200323003239 |
| Provider Name | Allyce Nicole Berkeley Caines |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114345501 PECOS PAC ID: 7911202668 Enrollment ID: I20200331000953 |
| Provider Name | Shivangi Lohia |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1801234927 PECOS PAC ID: 3678872884 Enrollment ID: I20200403002634 |
| Provider Name | Samantha Raffee |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1992048748 PECOS PAC ID: 6901034297 Enrollment ID: I20200406001098 |
| Provider Name | Supriya Raina-hukku |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1871795815 PECOS PAC ID: 2860653276 Enrollment ID: I20200413002682 |
| Provider Name | Amir Banihashemi |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1891174165 PECOS PAC ID: 1850721655 Enrollment ID: I20200419000200 |
| Provider Name | Sana Chams |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1730531146 PECOS PAC ID: 4183958226 Enrollment ID: I20200421002834 |
| Provider Name | Daniel Adam Lyons |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1346686722 PECOS PAC ID: 4486960127 Enrollment ID: I20200430001931 |
| Provider Name | Philip A Riley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851820518 PECOS PAC ID: 0042641201 Enrollment ID: I20200504001690 |
| Provider Name | Brian Kevin Theisen |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1407246226 PECOS PAC ID: 1658664941 Enrollment ID: I20200506001770 |
| Provider Name | Anthony C Tam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326490046 PECOS PAC ID: 9739472507 Enrollment ID: I20200511002340 |
| Provider Name | Alexandra Deporre |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1467831065 PECOS PAC ID: 0648587147 Enrollment ID: I20200511002997 |
| Provider Name | David Michael Bergman |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1013302397 PECOS PAC ID: 9436442316 Enrollment ID: I20200518002418 |
| Provider Name | Wei Liu |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1639445455 PECOS PAC ID: 6507004983 Enrollment ID: I20200518002889 |
| Provider Name | Kazem Mahmoud Osman |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518495225 PECOS PAC ID: 5092082479 Enrollment ID: I20200602002587 |
| Provider Name | Tyler David Kupchick |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1306370333 PECOS PAC ID: 1153608146 Enrollment ID: I20200609000375 |
| Provider Name | Rony Shabou |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982131355 PECOS PAC ID: 5193094217 Enrollment ID: I20200612002172 |
| Provider Name | Huiting Tina Chen |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1891082343 PECOS PAC ID: 7416263496 Enrollment ID: I20200616001538 |
| Provider Name | Mousab Mustafa Eteer |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1003201971 PECOS PAC ID: 5698049484 Enrollment ID: I20200623003057 |
| Provider Name | Derek Rizzo |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1609261098 PECOS PAC ID: 5698011542 Enrollment ID: I20200624000557 |
| Provider Name | Mahir H Alsalman |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1801195003 PECOS PAC ID: 2769805019 Enrollment ID: I20200706002001 |
| Provider Name | Alik Renatovich Saidov |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1396954525 PECOS PAC ID: 3173792736 Enrollment ID: I20200819002509 |
| Provider Name | Emily Miner |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1578910733 PECOS PAC ID: 9234420159 Enrollment ID: I20200928001705 |
| Provider Name | Michael Morgan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1245659283 PECOS PAC ID: 5597056523 Enrollment ID: I20201211001470 |
| Provider Name | Tarita Thomas |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1659572014 PECOS PAC ID: 1759537566 Enrollment ID: I20210201001204 |
| Provider Name | Kyle Gaetano Miletic |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1407240492 PECOS PAC ID: 8820308273 Enrollment ID: I20210510001511 |
| Provider Name | Joshua Joseph Won |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558898403 PECOS PAC ID: 1153697115 Enrollment ID: I20210518001231 |
| Provider Name | Yamin Sallowm |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1699138008 PECOS PAC ID: 7517251762 Enrollment ID: I20210525001905 |
| Provider Name | Christopher Do Elia |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1386081677 PECOS PAC ID: 7416378385 Enrollment ID: I20210608002473 |
| Provider Name | William J C Palmer |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1710419783 PECOS PAC ID: 3274803267 Enrollment ID: I20210624001216 |
| Provider Name | Omar Ahmed Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730617135 PECOS PAC ID: 2961778832 Enrollment ID: I20210629000539 |
| Provider Name | Ikenna Okereke |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1194980219 PECOS PAC ID: 8224190764 Enrollment ID: I20210726001135 |
| Provider Name | Mays Mohammad Alatiyat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497240006 PECOS PAC ID: 0941604581 Enrollment ID: I20210804002624 |
| Provider Name | Lawrence Kashat |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1205290137 PECOS PAC ID: 0244525137 Enrollment ID: I20210809000129 |
| Provider Name | Nazila Azordegan |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1003589656 PECOS PAC ID: 4385040955 Enrollment ID: I20210907002160 |
| Provider Name | Syed Ahmed Ali |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1164800546 PECOS PAC ID: 5799090148 Enrollment ID: I20210910001145 |
| Provider Name | Imtiaz Khan |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1306137666 PECOS PAC ID: 3072849942 Enrollment ID: I20210917001455 |
| Provider Name | Katherine A Bill |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346733979 PECOS PAC ID: 3274888995 Enrollment ID: I20211007002290 |
| Provider Name | Qing Chang |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1245640044 PECOS PAC ID: 7618212523 Enrollment ID: I20211021000846 |
| Provider Name | Stephen Spadafore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982138442 PECOS PAC ID: 5890064042 Enrollment ID: I20211027001420 |
| Provider Name | Khaled Adil |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1669944237 PECOS PAC ID: 0648517896 Enrollment ID: I20211203001272 |
| Provider Name | Nikhath Zeeshan |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1639458813 PECOS PAC ID: 1658595269 Enrollment ID: I20211214002899 |
| Provider Name | Hnin Lwin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1528547932 PECOS PAC ID: 5890038285 Enrollment ID: I20220526002802 |
| Provider Name | Raad Al Shaikhli |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1326433483 PECOS PAC ID: 5698073492 Enrollment ID: I20220601001067 |
| Provider Name | Miriam Jaziri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881190593 PECOS PAC ID: 0143564575 Enrollment ID: I20220601002744 |
| Provider Name | Tahsin Salam Nodi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093377210 PECOS PAC ID: 2961881396 Enrollment ID: I20220615001851 |
| Provider Name | John Mitchell |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1659360378 PECOS PAC ID: 9830161157 Enrollment ID: I20220627002037 |
| Provider Name | Emmanuel Awdishu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720630205 PECOS PAC ID: 6204163306 Enrollment ID: I20220630000178 |
| Provider Name | Eric Granowicz |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1750776985 PECOS PAC ID: 9931455052 Enrollment ID: I20220719003012 |
| Provider Name | Hassan A Nasser |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1154875987 PECOS PAC ID: 5294020947 Enrollment ID: I20220725000941 |
| Provider Name | Christine Rima Acho |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1689033748 PECOS PAC ID: 2466751821 Enrollment ID: I20220803000777 |
| Provider Name | Derek John Semaan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1679922876 PECOS PAC ID: 8628339843 Enrollment ID: I20220805001683 |
| Provider Name | Minh Quan Vu |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1609484641 PECOS PAC ID: 1456756055 Enrollment ID: I20220822002164 |
| Provider Name | Sonja Llancari |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1811559867 PECOS PAC ID: 1456688555 Enrollment ID: I20220831003288 |
| Provider Name | Savreet Kaur Singh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508412891 PECOS PAC ID: 9234469800 Enrollment ID: I20220901001435 |
| Provider Name | Abdulbaset M Salim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104385061 PECOS PAC ID: 8123350626 Enrollment ID: I20220919001792 |
| Provider Name | Jonathan Cudnik |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1285920538 PECOS PAC ID: 7113173337 Enrollment ID: I20221029000174 |
| Provider Name | Maher Khadra |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1669031738 PECOS PAC ID: 7012241268 Enrollment ID: I20221121000487 |
| Provider Name | Abdul Kader Tabbara |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1528329547 PECOS PAC ID: 0345472205 Enrollment ID: I20221123002228 |
| Provider Name | Miles Jackson |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1336515295 PECOS PAC ID: 7719356435 Enrollment ID: I20221219002286 |
| Provider Name | Abhishek Satishchandran |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1952895203 PECOS PAC ID: 9436405438 Enrollment ID: I20230104001025 |
| Provider Name | Emeka Nchekwube |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1306819826 PECOS PAC ID: 3072566900 Enrollment ID: I20230303001684 |
| Provider Name | Lauren Sibeck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265995013 PECOS PAC ID: 6103159876 Enrollment ID: I20230315000155 |
| Provider Name | Katherine Anne Cox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942520424 PECOS PAC ID: 7911149240 Enrollment ID: I20230316000917 |
| Provider Name | Khaled A Almadhoun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710544630 PECOS PAC ID: 8022340470 Enrollment ID: I20230404001369 |
| Provider Name | Essam Tellawi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1093715690 PECOS PAC ID: 2365497070 Enrollment ID: I20230428002032 |
| Provider Name | Husam Alghanem |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1972035020 PECOS PAC ID: 6406103290 Enrollment ID: I20230502001184 |
| Provider Name | Jonathon Walter Vargo |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1811438245 PECOS PAC ID: 5597037523 Enrollment ID: I20230503003419 |
| Provider Name | Mohamed El Fakiy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073139788 PECOS PAC ID: 8628491511 Enrollment ID: I20230504002023 |
| Provider Name | Alexander L Brown |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1467017699 PECOS PAC ID: 1557726999 Enrollment ID: I20230508001727 |
| Provider Name | Jaclyn Elizabeth Sylvain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891314795 PECOS PAC ID: 1759747561 Enrollment ID: I20230522001611 |
| Provider Name | Juan Ed Torres-reveron |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1689858706 PECOS PAC ID: 0648586172 Enrollment ID: I20230531001073 |
| Provider Name | Athar Ghannam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295351500 PECOS PAC ID: 9931521416 Enrollment ID: I20230914003402 |
| Provider Name | Hamead Moshrefi |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1891173696 PECOS PAC ID: 3678828670 Enrollment ID: I20231009001133 |
| Provider Name | Abigail Smith |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1437618345 PECOS PAC ID: 1557727252 Enrollment ID: I20231107002123 |
| Provider Name | Matthew M Epelman |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1568922854 PECOS PAC ID: 2860841632 Enrollment ID: I20231206001097 |
| Provider Name | Muhanad Taha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679005037 PECOS PAC ID: 6204103195 Enrollment ID: I20240123000593 |
| Provider Name | Gunwant S Mallik |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1376527663 PECOS PAC ID: 5294639514 Enrollment ID: I20240424002205 |
| Provider Name | Gustavo Arriola |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1417035510 PECOS PAC ID: 5395711535 Enrollment ID: I20240514001461 |
| Provider Name | Radhika Sukumar Sheth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285296343 PECOS PAC ID: 9739555483 Enrollment ID: I20240522001848 |
| Provider Name | Yaw Sarpong |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1073779435 PECOS PAC ID: 7214188101 Enrollment ID: I20240525000355 |
| Provider Name | James Edmund Mueller |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1841785359 PECOS PAC ID: 0446506307 Enrollment ID: I20240603001716 |
Diagnostic Ultrasound Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2575 Spring Arbor Rd, Suite 200, Jackson, MI 49203 Phone: 517-784-0020 Fax: 517-787-8329 | |
Aaron Van Wagnen Md Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1310 Greenwood Ave, Jackson, MI 49203 Phone: 517-787-1990 Fax: 517-787-9183 | |
Jackson Family Medical Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 724 W Franklin St, Jackson, MI 49201 Phone: 517-784-3100 Fax: 517-784-3200 | |
Lorna G. Pinson, Md Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 744 W Michigan Ave, Suite 101, Jackson, MI 49201 Phone: 517-782-2540 Fax: 517-782-1560 | |
Mid-michigan Health Centers Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 214 N West Ave, Jackson, MI 49201 Phone: 517-784-9189 Fax: 517-784-9657 | |
Henry Ford Allegiance Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 N East Ave, Jackson, MI 49201 Phone: 517-788-4800 | |
Center For Family Health At Lifeways Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1200 N West Ave, Jackson, MI 49202 Phone: 517-748-5500 Fax: 517-780-9286 |