| Bronson Medical Group | |
|
451 Health Pkwy Paw Paw MI 49079-8242 | |
| (269) 657-2550 | |
| (269) 657-2285 |
| Full Name | Bronson Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 451 Health Pkwy, Paw Paw, Michigan |
| Authorized Official Name and Position | Rebecca East (SVP, CFO) |
| Authorized Official Contact | 2693416000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bronson Medical Group 301 John St Box 42 Kalamazoo MI 49007-5295 Ph: (269) 341-7806 | Bronson Medical Group 451 Health Pkwy Paw Paw MI 49079-8242 Ph: (269) 657-2550 |
| NPI Number | 1235131137 |
|---|---|
| Provider Enumeration Date | 08/11/2005 |
| Last Update Date | 11/27/2023 |
| Medicare PECOS PAC ID | 9032008495 |
|---|---|
| Medicare Enrollment ID | O20051027001022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235131137 | NPI | - | NPPES |
| 238546 | Other | RHC-DECATUR | |
| 238601 | Other | RHC-PAW PAW | |
| 238585 | Other | RHC-MARCELLUS | |
| 238600 | Other | RHC-LAWTON |
| Provider Name | Manish Sharma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194836858 PECOS PAC ID: 4880594704 Enrollment ID: I20040108001092 |
| Provider Name | Andrew J Gordon |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194761924 PECOS PAC ID: 1254230923 Enrollment ID: I20040115000257 |
| Provider Name | Robin R Murphy |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1215917869 PECOS PAC ID: 5890697163 Enrollment ID: I20040126000819 |
| Provider Name | Philip G Borozan |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1326086935 PECOS PAC ID: 6709798283 Enrollment ID: I20040308000510 |
| Provider Name | Naji M Khairallah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710963970 PECOS PAC ID: 5193616118 Enrollment ID: I20040322000151 |
| Provider Name | Anthony Wayne Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417922568 PECOS PAC ID: 8729978358 Enrollment ID: I20040322000202 |
| Provider Name | Hugh Mark Sanchez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306829809 PECOS PAC ID: 2668362294 Enrollment ID: I20040322000253 |
| Provider Name | Sally Johanna Van Sweden |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1053394551 PECOS PAC ID: 2567352198 Enrollment ID: I20040322000293 |
| Provider Name | Hussein Z Akl |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699757849 PECOS PAC ID: 8921998550 Enrollment ID: I20040322000380 |
| Provider Name | Rose M Roth Bowersock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417937020 PECOS PAC ID: 9830081405 Enrollment ID: I20040327000386 |
| Provider Name | Tina Celeste Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013997659 PECOS PAC ID: 7719879386 Enrollment ID: I20040327000404 |
| Provider Name | Michael Raphelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225008790 PECOS PAC ID: 3072507805 Enrollment ID: I20040413001510 |
| Provider Name | Nilanjan B Gajare |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972616191 PECOS PAC ID: 5597747550 Enrollment ID: I20040603000373 |
| Provider Name | Shaza Zayzafoon-mosier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255304358 PECOS PAC ID: 5496730723 Enrollment ID: I20040622000053 |
| Provider Name | Scott M Peterson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1649250242 PECOS PAC ID: 3870560238 Enrollment ID: I20040914001326 |
| Provider Name | Keith G Seifert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801835541 PECOS PAC ID: 6608844436 Enrollment ID: I20040920001146 |
| Provider Name | Tamim Salman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508846940 PECOS PAC ID: 3072572346 Enrollment ID: I20041004000874 |
| Provider Name | Earl Norman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1962471185 PECOS PAC ID: 0749278299 Enrollment ID: I20041005000209 |
| Provider Name | James K Mackay |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982684320 PECOS PAC ID: 3173588613 Enrollment ID: I20041124000307 |
| Provider Name | Ernest J Spirito |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962479618 PECOS PAC ID: 3577512607 Enrollment ID: I20050115000113 |
| Provider Name | Gayle Waldenmaier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871639492 PECOS PAC ID: 2961452917 Enrollment ID: I20050127000097 |
| Provider Name | Carolina Flickinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295717262 PECOS PAC ID: 8729030309 Enrollment ID: I20050211000083 |
| Provider Name | Sajid Hussain |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073545133 PECOS PAC ID: 7719934546 Enrollment ID: I20050405000205 |
| Provider Name | Younho Chung |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881898104 PECOS PAC ID: 3577504521 Enrollment ID: I20050524000512 |
| Provider Name | Reuben Dwayne Eliuk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205987724 PECOS PAC ID: 6002850948 Enrollment ID: I20050613000553 |
| Provider Name | David J Christ |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1609819705 PECOS PAC ID: 1658276423 Enrollment ID: I20050620000572 |
| Provider Name | Thomas A Keller |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1972523918 PECOS PAC ID: 3779529722 Enrollment ID: I20050630000191 |
| Provider Name | Kwsai Al Rahhal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639159247 PECOS PAC ID: 1951347301 Enrollment ID: I20050707000361 |
| Provider Name | Cecilia M Prophit |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1871532705 PECOS PAC ID: 9335051812 Enrollment ID: I20050817000141 |
| Provider Name | Miranda R Makulski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164489316 PECOS PAC ID: 5395776884 Enrollment ID: I20050824000806 |
| Provider Name | Sunil P John |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306953542 PECOS PAC ID: 3375576762 Enrollment ID: I20050915000926 |
| Provider Name | Penny Shek Rathburn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063555944 PECOS PAC ID: 2062447808 Enrollment ID: I20050930000150 |
| Provider Name | Mirjana Stancic |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073656963 PECOS PAC ID: 1355376096 Enrollment ID: I20050930000217 |
| Provider Name | Douglas J Wunderly |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1952321952 PECOS PAC ID: 1557256518 Enrollment ID: I20051005000758 |
| Provider Name | Shadi M Fahs |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1144209883 PECOS PAC ID: 9436174687 Enrollment ID: I20051007000106 |
| Provider Name | Julia R Koestner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760460562 PECOS PAC ID: 5597780353 Enrollment ID: I20051011000341 |
| Provider Name | Bruce Arthur Rowe |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1205890464 PECOS PAC ID: 1355372772 Enrollment ID: I20051017000242 |
| Provider Name | Amy Lynne Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881677383 PECOS PAC ID: 2961420567 Enrollment ID: I20051102000661 |
| Provider Name | Kathy Joanne Brittan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780666925 PECOS PAC ID: 3375561970 Enrollment ID: I20051107000671 |
| Provider Name | Joel Hubert Reinoehl |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1326068347 PECOS PAC ID: 5092600056 Enrollment ID: I20051123000283 |
| Provider Name | Christopher Rogers |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1013937036 PECOS PAC ID: 1355236316 Enrollment ID: I20051123000302 |
| Provider Name | John Frank Schonder |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1184644114 PECOS PAC ID: 7315967189 Enrollment ID: I20051123000328 |
| Provider Name | Michael Stanley Pawlik |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1043230071 PECOS PAC ID: 5496775264 Enrollment ID: I20051123000335 |
| Provider Name | Robert A Williams |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1730109778 PECOS PAC ID: 2668492430 Enrollment ID: I20051123000351 |
| Provider Name | Melissa A Davidson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740259332 PECOS PAC ID: 1759302557 Enrollment ID: I20051208000264 |
| Provider Name | Nadeem M Mirza |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437159597 PECOS PAC ID: 6507858214 Enrollment ID: I20051221000416 |
| Provider Name | James L Loker |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1255311692 PECOS PAC ID: 6103832159 Enrollment ID: I20060228000405 |
| Provider Name | Sarat K Vaddineni |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1659328508 PECOS PAC ID: 0446263917 Enrollment ID: I20060731000049 |
| Provider Name | Oreste Marco Fabio Romeo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1174566350 PECOS PAC ID: 5395748529 Enrollment ID: I20060808000568 |
| Provider Name | Gianna L Service |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013939859 PECOS PAC ID: 4284639931 Enrollment ID: I20061002000301 |
| Provider Name | Todd C Bennett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548233562 PECOS PAC ID: 5496772915 Enrollment ID: I20061128000067 |
| Provider Name | Margaret Z Maciorowski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427169135 PECOS PAC ID: 8921006875 Enrollment ID: I20061201000223 |
| Provider Name | Connie Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861462996 PECOS PAC ID: 7618976911 Enrollment ID: I20061214000445 |
| Provider Name | William C Cartmill |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568444164 PECOS PAC ID: 0941210785 Enrollment ID: I20070111000269 |
| Provider Name | Allan Caudill |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1346224086 PECOS PAC ID: 8527037001 Enrollment ID: I20070126000539 |
| Provider Name | Laura C Ford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326047358 PECOS PAC ID: 9739282252 Enrollment ID: I20070321000102 |
| Provider Name | Camelia Adab Merati |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467474312 PECOS PAC ID: 7719081249 Enrollment ID: I20070322000429 |
| Provider Name | Diane L Peirce |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265450290 PECOS PAC ID: 9931203676 Enrollment ID: I20070405000175 |
| Provider Name | Jennifer M Carman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952453474 PECOS PAC ID: 5496855348 Enrollment ID: I20070709000071 |
| Provider Name | Brett J Eliuk |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1871714915 PECOS PAC ID: 3476654443 Enrollment ID: I20070720000093 |
| Provider Name | Tracy J Pierce |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255471488 PECOS PAC ID: 4385745330 Enrollment ID: I20070720000740 |
| Provider Name | Jill E Gamble |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396828703 PECOS PAC ID: 9739274325 Enrollment ID: I20070927000302 |
| Provider Name | Lukasz Niec |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124224183 PECOS PAC ID: 5496843971 Enrollment ID: I20071116000313 |
| Provider Name | Steve E Reiman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205835535 PECOS PAC ID: 5698754646 Enrollment ID: I20071221000067 |
| Provider Name | Martin F Hoffman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891794160 PECOS PAC ID: 9537148572 Enrollment ID: I20080107000846 |
| Provider Name | Jessica Sue Parr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487860557 PECOS PAC ID: 5698856177 Enrollment ID: I20080123000134 |
| Provider Name | Michael Pack |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1508822966 PECOS PAC ID: 9436187093 Enrollment ID: I20080710000458 |
| Provider Name | Robert Ward Selfe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003038605 PECOS PAC ID: 3072687078 Enrollment ID: I20080809000020 |
| Provider Name | Todd C Welton |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1063601250 PECOS PAC ID: 6204901366 Enrollment ID: I20080825000282 |
| Provider Name | Stanislav Y Tinigin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538363999 PECOS PAC ID: 2668540360 Enrollment ID: I20081008000328 |
| Provider Name | Gordon Ray Bleil |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295847739 PECOS PAC ID: 4688742257 Enrollment ID: I20081009000194 |
| Provider Name | Quentin Calvert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700888674 PECOS PAC ID: 6406916113 Enrollment ID: I20081125000145 |
| Provider Name | Christina M Vaughn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801043336 PECOS PAC ID: 8729142054 Enrollment ID: I20090130000356 |
| Provider Name | Matthew S Blair |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548225634 PECOS PAC ID: 0840357729 Enrollment ID: I20090319000597 |
| Provider Name | Robert N Winter |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174633135 PECOS PAC ID: 9234286626 Enrollment ID: I20090422000532 |
| Provider Name | James L Hunt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043279029 PECOS PAC ID: 8426123225 Enrollment ID: I20090617000553 |
| Provider Name | Saad A Shebrain |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1427240589 PECOS PAC ID: 6507910973 Enrollment ID: I20090819000617 |
| Provider Name | Gene C Yu |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1255354262 PECOS PAC ID: 8224184502 Enrollment ID: I20090929000337 |
| Provider Name | Karen C Alcaraz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922199900 PECOS PAC ID: 7911045117 Enrollment ID: I20091109000435 |
| Provider Name | Cindi K Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306816889 PECOS PAC ID: 9335280379 Enrollment ID: I20100112000838 |
| Provider Name | Tempest A Allen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1699755207 PECOS PAC ID: 4981747961 Enrollment ID: I20100130000325 |
| Provider Name | Alan A Halpern |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1528078789 PECOS PAC ID: 4688717804 Enrollment ID: I20100210000020 |
| Provider Name | Dennis Clifford Powless |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548596455 PECOS PAC ID: 2264575356 Enrollment ID: I20100212000071 |
| Provider Name | Steven M Trillet |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740250398 PECOS PAC ID: 5991830895 Enrollment ID: I20100317000629 |
| Provider Name | Michael F Chen |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1215904305 PECOS PAC ID: 7113054024 Enrollment ID: I20100426000289 |
| Provider Name | Leslie Steven Szeles |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1699710566 PECOS PAC ID: 8628980851 Enrollment ID: I20100429000294 |
| Provider Name | Robert R Isacksen |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1972546059 PECOS PAC ID: 7719899293 Enrollment ID: I20100429000635 |
| Provider Name | Lisa A Miller |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1427065929 PECOS PAC ID: 3779587274 Enrollment ID: I20100607000050 |
| Provider Name | Susan P Heinrich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699887125 PECOS PAC ID: 4981760410 Enrollment ID: I20100717000067 |
| Provider Name | John W Kavanaugh |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609858844 PECOS PAC ID: 5395755136 Enrollment ID: I20100805000862 |
| Provider Name | Thomas J Huggett |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912989153 PECOS PAC ID: 3577573310 Enrollment ID: I20100806000459 |
| Provider Name | Lester Burkow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639166747 PECOS PAC ID: 3678607975 Enrollment ID: I20100820000924 |
| Provider Name | Alessandra R Chatson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427253368 PECOS PAC ID: 8224122734 Enrollment ID: I20100902001107 |
| Provider Name | Christopher Alcaraz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659305548 PECOS PAC ID: 5799760104 Enrollment ID: I20100909001169 |
| Provider Name | Mark Jonathan Sytsma |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1962597278 PECOS PAC ID: 9436203890 Enrollment ID: I20100929000839 |
| Provider Name | Ed A Itawi |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1366645574 PECOS PAC ID: 4486847191 Enrollment ID: I20101026000345 |
| Provider Name | Zebi Naz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114128501 PECOS PAC ID: 9032303201 Enrollment ID: I20101101001581 |
| Provider Name | Sridhar Chalasani |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1063494607 PECOS PAC ID: 6709967748 Enrollment ID: I20101103000085 |
| Provider Name | Ahed Zayzafoon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023340700 PECOS PAC ID: 0446446694 Enrollment ID: I20101130000519 |
| Provider Name | Nagaraju Choragudi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467490839 PECOS PAC ID: 6305738907 Enrollment ID: I20101228000231 |
| Provider Name | Deborah Lafferty Bohm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104156983 PECOS PAC ID: 0345429528 Enrollment ID: I20110119001278 |
| Provider Name | Jose A Deleon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093913246 PECOS PAC ID: 9537349253 Enrollment ID: I20110211000386 |
| Provider Name | Jagadish Hegde |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861696346 PECOS PAC ID: 7517159833 Enrollment ID: I20110520000439 |
| Provider Name | Jahnavi Mithyantha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417151911 PECOS PAC ID: 5193917417 Enrollment ID: I20110520000558 |
| Provider Name | Jessica L Keto |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356569933 PECOS PAC ID: 0345428678 Enrollment ID: I20110708000523 |
| Provider Name | Shadi I Jibawi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568622686 PECOS PAC ID: 2466620182 Enrollment ID: I20110725000709 |
| Provider Name | Madhu M Batchu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174691604 PECOS PAC ID: 9739358185 Enrollment ID: I20110802000037 |
| Provider Name | Alison M Stoughton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821387010 PECOS PAC ID: 5395914071 Enrollment ID: I20110815000449 |
| Provider Name | Ali Ghasham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881894459 PECOS PAC ID: 9931379864 Enrollment ID: I20110831000553 |
| Provider Name | Sarah M Hughes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881820330 PECOS PAC ID: 7810160611 Enrollment ID: I20111021000383 |
| Provider Name | Kimberly A Applebey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558646976 PECOS PAC ID: 1951576982 Enrollment ID: I20111202000411 |
| Provider Name | Lisa R Woodruff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346510252 PECOS PAC ID: 6800057613 Enrollment ID: I20120420000497 |
| Provider Name | Karthik Vijayaraghavan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124295167 PECOS PAC ID: 5193981025 Enrollment ID: I20120723000247 |
| Provider Name | Rafid Y Mansour |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265662308 PECOS PAC ID: 9133375991 Enrollment ID: I20120809000634 |
| Provider Name | Marisa Leighton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437404746 PECOS PAC ID: 3678721529 Enrollment ID: I20120918000538 |
| Provider Name | Elizabeth N Doorn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487907739 PECOS PAC ID: 9739331919 Enrollment ID: I20121217000024 |
| Provider Name | Ashley M Jones Zigterman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154683720 PECOS PAC ID: 3173777661 Enrollment ID: I20130211000106 |
| Provider Name | Beth J Makowski-shell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477739787 PECOS PAC ID: 7315191830 Enrollment ID: I20130211000362 |
| Provider Name | Deepak Garg |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1952558769 PECOS PAC ID: 1456593110 Enrollment ID: I20130808000266 |
| Provider Name | Stephen J Morrow |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023249364 PECOS PAC ID: 2062654635 Enrollment ID: I20130809000671 |
| Provider Name | Andrea N Fleuren |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659692945 PECOS PAC ID: 0042453797 Enrollment ID: I20130827000835 |
| Provider Name | Lindsay Wriston |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952531469 PECOS PAC ID: 4385878438 Enrollment ID: I20131004000067 |
| Provider Name | Jasmine E Oliver |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205149325 PECOS PAC ID: 3577790708 Enrollment ID: I20131216000613 |
| Provider Name | Yelena V Isayenko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043505399 PECOS PAC ID: 1658509310 Enrollment ID: I20140102001236 |
| Provider Name | Amber Nash-guilford |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1538459813 PECOS PAC ID: 6406099779 Enrollment ID: I20140226000545 |
| Provider Name | Edward Sternaman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801994462 PECOS PAC ID: 1658391859 Enrollment ID: I20140312001023 |
| Provider Name | Dexter D Fossitt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639461932 PECOS PAC ID: 8527212778 Enrollment ID: I20140602000304 |
| Provider Name | Steven M Allan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891106902 PECOS PAC ID: 8426272188 Enrollment ID: I20140619001087 |
| Provider Name | Patricia L Fick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457639361 PECOS PAC ID: 7911136973 Enrollment ID: I20140630000632 |
| Provider Name | Eric J Yoder |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487947925 PECOS PAC ID: 8729210844 Enrollment ID: I20140701001412 |
| Provider Name | Tamayi Bwititi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558655464 PECOS PAC ID: 2769607753 Enrollment ID: I20140708000098 |
| Provider Name | Joseph B Wheeler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992056725 PECOS PAC ID: 7315163276 Enrollment ID: I20140729002820 |
| Provider Name | Caralyn K Dehaan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750673711 PECOS PAC ID: 9537386370 Enrollment ID: I20140819000417 |
| Provider Name | David J Beard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679989370 PECOS PAC ID: 7719105246 Enrollment ID: I20140826000728 |
| Provider Name | Wade W Kang |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1164612453 PECOS PAC ID: 2860687456 Enrollment ID: I20140829001002 |
| Provider Name | Sara B Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467858118 PECOS PAC ID: 4587988084 Enrollment ID: I20150109000942 |
| Provider Name | Parth B Amin |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1326283730 PECOS PAC ID: 8729240163 Enrollment ID: I20150224000943 |
| Provider Name | Kyle Reece Ver Steeg |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1356494710 PECOS PAC ID: 5193816502 Enrollment ID: I20150423001535 |
| Provider Name | Stephen L Mcginnis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275826711 PECOS PAC ID: 7517199490 Enrollment ID: I20150521002257 |
| Provider Name | Christopher Terrance Ombrello |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1225096506 PECOS PAC ID: 2961502273 Enrollment ID: I20150528001483 |
| Provider Name | Gagan Preet Garcha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710237821 PECOS PAC ID: 3072745967 Enrollment ID: I20150611002197 |
| Provider Name | Quratulain Chaudhry |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1982917282 PECOS PAC ID: 9032343082 Enrollment ID: I20150622000211 |
| Provider Name | Pearce J Dupuis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770856932 PECOS PAC ID: 2466763875 Enrollment ID: I20150625001118 |
| Provider Name | Katherine A Bell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033502133 PECOS PAC ID: 9537471891 Enrollment ID: I20150630001476 |
| Provider Name | Ashutosh Goel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174570188 PECOS PAC ID: 4789686759 Enrollment ID: I20150706000114 |
| Provider Name | Rebecca E Stafford |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811157191 PECOS PAC ID: 2062687239 Enrollment ID: I20150710000292 |
| Provider Name | Betsy Marie Becker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427433176 PECOS PAC ID: 4880909241 Enrollment ID: I20150813010473 |
| Provider Name | Janet Myung Hur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336465475 PECOS PAC ID: 8527184365 Enrollment ID: I20150818005250 |
| Provider Name | Steven F Shelden |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669633368 PECOS PAC ID: 7315252475 Enrollment ID: I20150818005839 |
| Provider Name | Katrina N Barrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215312202 PECOS PAC ID: 2062728249 Enrollment ID: I20150902002361 |
| Provider Name | Christine Dugan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427317858 PECOS PAC ID: 1456582956 Enrollment ID: I20150903000465 |
| Provider Name | Osarenomase Egharevba |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083913230 PECOS PAC ID: 8527284520 Enrollment ID: I20150917000835 |
| Provider Name | Mark R Nikkel |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1699762336 PECOS PAC ID: 1759478928 Enrollment ID: I20150929001808 |
| Provider Name | Brian A Akrami |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1750320958 PECOS PAC ID: 0941281323 Enrollment ID: I20151007002416 |
| Provider Name | Kimberly A Hybels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609259837 PECOS PAC ID: 3779892880 Enrollment ID: I20151012000880 |
| Provider Name | Aaron Lee Hisel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114398591 PECOS PAC ID: 3870803984 Enrollment ID: I20151102001539 |
| Provider Name | Bethany Vinatieri |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053743385 PECOS PAC ID: 6507176575 Enrollment ID: I20151103000902 |
| Provider Name | Jenna T Ruple |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437418589 PECOS PAC ID: 6305091695 Enrollment ID: I20151116002136 |
| Provider Name | Sarah R Cohen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053753970 PECOS PAC ID: 8325348527 Enrollment ID: I20151119001240 |
| Provider Name | Amanda A Wehner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356709919 PECOS PAC ID: 6204134463 Enrollment ID: I20160421000604 |
| Provider Name | Ikechukwu Chris Ilochonwu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558505438 PECOS PAC ID: 5991940652 Enrollment ID: I20160505001705 |
| Provider Name | Rebecca J Markus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912366535 PECOS PAC ID: 7416246640 Enrollment ID: I20160511002018 |
| Provider Name | Sara Lynn Deatsman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083976682 PECOS PAC ID: 0042446338 Enrollment ID: I20160610001774 |
| Provider Name | Sarah Renee Larson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1508152430 PECOS PAC ID: 9436450053 Enrollment ID: I20160628000127 |
| Provider Name | Kimberly Baker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720439979 PECOS PAC ID: 3375836646 Enrollment ID: I20160725000477 |
| Provider Name | Abbas El-khatib |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386709970 PECOS PAC ID: 7012200975 Enrollment ID: I20160729001081 |
| Provider Name | Abhishek Gupta |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1902194830 PECOS PAC ID: 8123337318 Enrollment ID: I20160802000238 |
| Provider Name | Stephanie Joan Croy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215372255 PECOS PAC ID: 7012149131 Enrollment ID: I20160802001087 |
| Provider Name | Barbara Oneil |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912350893 PECOS PAC ID: 2264726215 Enrollment ID: I20160815000134 |
| Provider Name | Jasper Mukwada |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558815787 PECOS PAC ID: 4981992856 Enrollment ID: I20161007001484 |
| Provider Name | Ilona Gocza Richards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376840371 PECOS PAC ID: 4183802812 Enrollment ID: I20161116002149 |
| Provider Name | Renee Elizabeth Lacoss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295287852 PECOS PAC ID: 0941580658 Enrollment ID: I20161214001474 |
| Provider Name | Catherine M Vandyk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992249510 PECOS PAC ID: 4385926658 Enrollment ID: I20170120002106 |
| Provider Name | Sarah J Frederick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144760604 PECOS PAC ID: 0547545212 Enrollment ID: I20170320001170 |
| Provider Name | Barbara E Kurlan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619940830 PECOS PAC ID: 7810956018 Enrollment ID: I20170327002888 |
| Provider Name | Mohamed E Ghonimy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821437427 PECOS PAC ID: 0446548101 Enrollment ID: I20170509001931 |
| Provider Name | Theotonius J Gomes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205276664 PECOS PAC ID: 5294965471 Enrollment ID: I20170609001190 |
| Provider Name | Kristen Degroff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376078782 PECOS PAC ID: 4385912617 Enrollment ID: I20170609001238 |
| Provider Name | Marci Melnick-butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962938365 PECOS PAC ID: 4183993496 Enrollment ID: I20170629002216 |
| Provider Name | Pamela J Blakemore Ray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578090536 PECOS PAC ID: 0143590125 Enrollment ID: I20170725000343 |
| Provider Name | Veronica Rothney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003153594 PECOS PAC ID: 8022380534 Enrollment ID: I20170817003693 |
| Provider Name | Leah M Markle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043732407 PECOS PAC ID: 1052683000 Enrollment ID: I20170825000906 |
| Provider Name | Christopher Holthof |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386160182 PECOS PAC ID: 6800161613 Enrollment ID: I20171004002320 |
| Provider Name | Hariton H Kousourou |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326133646 PECOS PAC ID: 7113116278 Enrollment ID: I20171011001064 |
| Provider Name | Rajeev R Malireddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467884775 PECOS PAC ID: 5597042556 Enrollment ID: I20171101000311 |
| Provider Name | Atanas T Iliev |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1942612858 PECOS PAC ID: 6507122850 Enrollment ID: I20171102002045 |
| Provider Name | Julia Ridenour |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1780017384 PECOS PAC ID: 9335405505 Enrollment ID: I20171106000535 |
| Provider Name | Nina K Siagkris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881944072 PECOS PAC ID: 1153687298 Enrollment ID: I20171107000665 |
| Provider Name | Erin Vlietstra |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699187138 PECOS PAC ID: 8325305998 Enrollment ID: I20171207000135 |
| Provider Name | Judy Whitehurst |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104331347 PECOS PAC ID: 6709145188 Enrollment ID: I20180110000258 |
| Provider Name | Cynthia W Jubenville |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760982599 PECOS PAC ID: 9335402304 Enrollment ID: I20180405000181 |
| Provider Name | Allison Richards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942506902 PECOS PAC ID: 7416212204 Enrollment ID: I20180529000213 |
| Provider Name | Melissa Houser |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942250329 PECOS PAC ID: 8527958503 Enrollment ID: I20180609000192 |
| Provider Name | Melinda Gail Abernethy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1427254226 PECOS PAC ID: 4486892056 Enrollment ID: I20180613003040 |
| Provider Name | Charles Clearwater |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790134740 PECOS PAC ID: 3072864388 Enrollment ID: I20180926001778 |
| Provider Name | Jennifer R Hall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356699045 PECOS PAC ID: 6608113709 Enrollment ID: I20190128002947 |
| Provider Name | Elizabeth Ann Heskett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700359387 PECOS PAC ID: 9537406558 Enrollment ID: I20190130000338 |
| Provider Name | Rebecca D Womble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760993042 PECOS PAC ID: 1052678182 Enrollment ID: I20190130000594 |
| Provider Name | Kimberley Ann Spitzner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386109189 PECOS PAC ID: 6800135831 Enrollment ID: I20190308000550 |
| Provider Name | Angela Newman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073086989 PECOS PAC ID: 0244572006 Enrollment ID: I20190425002554 |
| Provider Name | Gary Zachary White |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1104230523 PECOS PAC ID: 3375837214 Enrollment ID: I20190612000834 |
| Provider Name | Christopher F Hanzaker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376983205 PECOS PAC ID: 8426299215 Enrollment ID: I20190701001020 |
| Provider Name | Thomas Anders Gustav Franzon |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1740676295 PECOS PAC ID: 9638463649 Enrollment ID: I20190709002738 |
| Provider Name | Nilay Gandhi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972966539 PECOS PAC ID: 6305137910 Enrollment ID: I20190723003309 |
| Provider Name | Kateri Andrea Fitzgerald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265935282 PECOS PAC ID: 0840553004 Enrollment ID: I20190730003844 |
| Provider Name | Neeta V Karani |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1558660803 PECOS PAC ID: 5395049563 Enrollment ID: I20190731000372 |
| Provider Name | David M Eisinger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780036459 PECOS PAC ID: 8224322946 Enrollment ID: I20190912001318 |
| Provider Name | Deborah Faling |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053722199 PECOS PAC ID: 5698107688 Enrollment ID: I20191113000430 |
| Provider Name | Robin Jo Schoenheit |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609114768 PECOS PAC ID: 8628401148 Enrollment ID: I20191213000651 |
| Provider Name | John Bulko |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023542842 PECOS PAC ID: 5597195032 Enrollment ID: I20200423001556 |
| Provider Name | Zachary Virgin |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1851731103 PECOS PAC ID: 7719207745 Enrollment ID: I20200423003274 |
| Provider Name | Jessica Pochedly |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1376953661 PECOS PAC ID: 6103128608 Enrollment ID: I20200717000310 |
| Provider Name | Christopher Betzle |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1013329390 PECOS PAC ID: 1456577634 Enrollment ID: I20200806002092 |
| Provider Name | Kristen Duman Scholten |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1689036733 PECOS PAC ID: 0547556656 Enrollment ID: I20200819002315 |
| Provider Name | Heidi Limburg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932559333 PECOS PAC ID: 7911326962 Enrollment ID: I20200924003069 |
| Provider Name | Melissa Lynn Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649886607 PECOS PAC ID: 1052731130 Enrollment ID: I20201009002317 |
| Provider Name | Ana Mayari Diaz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396082889 PECOS PAC ID: 7618397944 Enrollment ID: I20201026001679 |
| Provider Name | Gabraelle Elizabeth Foune |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346875721 PECOS PAC ID: 0547671943 Enrollment ID: I20201116000529 |
| Provider Name | Jennifer H Hilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598364770 PECOS PAC ID: 5193136513 Enrollment ID: I20201116001385 |
| Provider Name | Justin Hutchison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184180804 PECOS PAC ID: 4183036213 Enrollment ID: I20201215001589 |
| Provider Name | Bonnie Joanne Vallance |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639773179 PECOS PAC ID: 8022421098 Enrollment ID: I20210112001191 |
| Provider Name | Rachel Ford Bass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114534443 PECOS PAC ID: 1052725678 Enrollment ID: I20210122000335 |
| Provider Name | April Christine Davenport |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639638182 PECOS PAC ID: 0840605838 Enrollment ID: I20210225001837 |
| Provider Name | Vikita D Walker-phillips |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023601564 PECOS PAC ID: 3375959810 Enrollment ID: I20210309001533 |
| Provider Name | Elizabeth Ramirez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154812931 PECOS PAC ID: 1254733363 Enrollment ID: I20210713000619 |
| Provider Name | Hye Rim Smith |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1215317110 PECOS PAC ID: 1153623202 Enrollment ID: I20210721002869 |
| Provider Name | Celeste Salvador-gonzalez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699210963 PECOS PAC ID: 4587067756 Enrollment ID: I20210726001996 |
| Provider Name | Sherry Michele Sanford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700455177 PECOS PAC ID: 9638572738 Enrollment ID: I20210727003447 |
| Provider Name | Jennifer L Lorenz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669013819 PECOS PAC ID: 3375948276 Enrollment ID: I20210816001688 |
| Provider Name | Amanda Alice Smelker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194398255 PECOS PAC ID: 5092110635 Enrollment ID: I20210820000552 |
| Provider Name | Kristin Lee Desrosiers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467888123 PECOS PAC ID: 0840695946 Enrollment ID: I20210827002322 |
| Provider Name | Nicole Marie Villanueva |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457479347 PECOS PAC ID: 3779981832 Enrollment ID: I20211005000892 |
| Provider Name | Allison Ewert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407428501 PECOS PAC ID: 8729486535 Enrollment ID: I20211008001405 |
| Provider Name | Ann Marie Tapper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144992983 PECOS PAC ID: 9537557855 Enrollment ID: I20211019001543 |
| Provider Name | John Hopkins |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538230032 PECOS PAC ID: 2466556980 Enrollment ID: I20211124001741 |
| Provider Name | Heather Lee De La Vara |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962052472 PECOS PAC ID: 5496145369 Enrollment ID: I20211208001625 |
| Provider Name | Michelle Marie Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518583202 PECOS PAC ID: 6709204449 Enrollment ID: I20220104002539 |
| Provider Name | Seth Van Heukelom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457734295 PECOS PAC ID: 5890008551 Enrollment ID: I20220113001076 |
| Provider Name | Katherine Elizabeth Hampton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972258481 PECOS PAC ID: 0244624302 Enrollment ID: I20220307001154 |
| Provider Name | Jonathon M Blais |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1881048213 PECOS PAC ID: 8123315991 Enrollment ID: I20220711002032 |
| Provider Name | Rhonda Jo Gola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003555368 PECOS PAC ID: 5698156941 Enrollment ID: I20220718001368 |
| Provider Name | Alisha Haniff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912466277 PECOS PAC ID: 3375973167 Enrollment ID: I20220719003337 |
| Provider Name | Terri Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215667175 PECOS PAC ID: 3173905775 Enrollment ID: I20220728002914 |
| Provider Name | Jessica Lynn Konal |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992296495 PECOS PAC ID: 4688939044 Enrollment ID: I20220815000963 |
| Provider Name | Lynne Betten Letchner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053666115 PECOS PAC ID: 1759766835 Enrollment ID: I20220912000642 |
| Provider Name | Hailey Santana |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831864875 PECOS PAC ID: 4587049317 Enrollment ID: I20220915000730 |
| Provider Name | Lucy Alberda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629780879 PECOS PAC ID: 1759751811 Enrollment ID: I20230105002566 |
| Provider Name | Meghan Rzeszutko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427754621 PECOS PAC ID: 5597130369 Enrollment ID: I20230408000217 |
| Provider Name | Eilidh Fiona Sture |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003425737 PECOS PAC ID: 8325406028 Enrollment ID: I20230627002316 |
| Provider Name | Pranay Vamsikrishna Pandrangi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1407377930 PECOS PAC ID: 9931478724 Enrollment ID: I20230712000838 |
| Provider Name | Emily Marie Schmitt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972232221 PECOS PAC ID: 4688034036 Enrollment ID: I20230717001518 |
| Provider Name | Graham Walker Mclaren |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1982193629 PECOS PAC ID: 1850656224 Enrollment ID: I20230804001012 |
| Provider Name | Cindy Marie Roman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194505578 PECOS PAC ID: 1759739527 Enrollment ID: I20231205001015 |
| Provider Name | Stephanie Ann Horton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417727090 PECOS PAC ID: 0749624054 Enrollment ID: I20240214003038 |
| Provider Name | Christopher Fowler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073161006 PECOS PAC ID: 0244678779 Enrollment ID: I20240403002605 |
Lakeview Family Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 404 Hazen Street, Paw Paw, MI 49079 Phone: 269-657-2550 Fax: 269-657-2285 | |
Bronson Lakeview Family Care-paw Paw Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 451 Health Pkwy, Paw Paw, MI 49079 Phone: 269-657-2550 Fax: 269-657-2285 | |
Star Health Multi-specialty Group Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 451 Health Parkway, Paw Paw, MI 49079 Phone: 269-657-8300 Fax: 269-657-8332 | |
Star Health Multispecialty Group P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 451 Health Pkwy, Paw Paw, MI 49079 Phone: 269-657-8300 |