| Cleveland Medical Associates, Pllc | |
|
1060 William Way Nw Cleveland TN 37312-4369 | |
| (423) 478-1050 | |
| (423) 478-1075 |
| Full Name | Cleveland Medical Associates, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1060 William Way Nw, Cleveland, Tennessee |
| Authorized Official Name and Position | Lisa Childers (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 4234781050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cleveland Medical Associates, Pllc 1060 William Way Nw Cleveland TN 37312-4369 Ph: (423) 478-1050 | Cleveland Medical Associates, Pllc 1060 William Way Nw Cleveland TN 37312-4369 Ph: (423) 478-1050 |
| NPI Number | 1093723330 |
|---|---|
| Provider Enumeration Date | 08/03/2006 |
| Last Update Date | 03/22/2011 |
| Medicare PECOS PAC ID | 7113952938 |
|---|---|
| Medicare Enrollment ID | O20050929001372 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093723330 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Maria J Tomczyk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497710040 PECOS PAC ID: 1456381698 Enrollment ID: I20050817000239 |
| Provider Name | Kamran Farrukh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760447205 PECOS PAC ID: 5597795740 Enrollment ID: I20050817000282 |
| Provider Name | Azhar S Sheikh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013972538 PECOS PAC ID: 2365472529 Enrollment ID: I20050817000332 |
| Provider Name | Holly D Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295763316 PECOS PAC ID: 4082617162 Enrollment ID: I20060809000433 |
| Provider Name | Garvin K Chastain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518933829 PECOS PAC ID: 2668477373 Enrollment ID: I20060930000040 |
| Provider Name | Daniel Vance |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932173028 PECOS PAC ID: 2668471228 Enrollment ID: I20061207000444 |
| Provider Name | Tami Brehen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700185469 PECOS PAC ID: 1759565070 Enrollment ID: I20110412000360 |
| Provider Name | Mary C Lipscomb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790127090 PECOS PAC ID: 6608002407 Enrollment ID: I20131127000934 |
| Provider Name | Nicole Bernatowicz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417159260 PECOS PAC ID: 4183860620 Enrollment ID: I20151215001093 |
| Provider Name | Kristy Alese Henegar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487134482 PECOS PAC ID: 5294072179 Enrollment ID: I20200513000741 |
| Provider Name | Leslie T Casteel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851918841 PECOS PAC ID: 2567881659 Enrollment ID: I20200923000186 |
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