| Colonnades Family Medicine Llc | |
|
101 Bradford Road Suite 220 Wexford PA 15090 | |
| (724) 940-5555 | |
| Not Available |
| Full Name | Colonnades Family Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 101 Bradford Road, Wexford, Pennsylvania |
| Authorized Official Name and Position | Desiree Beth Butter (OWNER) |
| Authorized Official Contact | 7249405555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Colonnades Family Medicine Llc 101 Bradford Road Suite 220 Wexford PA 15090 Ph: (724) 940-5555 | Colonnades Family Medicine Llc 101 Bradford Road Suite 220 Wexford PA 15090 Ph: (724) 940-5555 |
| NPI Number | 1316129240 |
|---|---|
| Provider Enumeration Date | 12/03/2007 |
| Last Update Date | 03/09/2016 |
| Medicare PECOS PAC ID | 9234114380 |
|---|---|
| Medicare Enrollment ID | O20040622001226 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316129240 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Desiree Beth Butter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780646539 PECOS PAC ID: 2769467810 Enrollment ID: I20040623000048 |
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