| Dmc Medical Group | |
|
29201 Telegraph Rd Ste 404n Southfield MI 48034-7647 | |
| (248) 450-3507 | |
| (248) 796-0177 |
| Full Name | Dmc Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 29201 Telegraph Rd Ste 404n, Southfield, Michigan |
| Authorized Official Name and Position | Brian Rasmus (VP, CFO TPR TENET) |
| Authorized Official Contact | 4698932532 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dmc Medical Group Po Box 18998 Belfast ME 04915-4084 Ph: (248) 455-0864 | Dmc Medical Group 29201 Telegraph Rd Ste 404n Southfield MI 48034-7647 Ph: (248) 450-3507 |
| NPI Number | 1073827101 |
|---|---|
| Provider Enumeration Date | 07/30/2010 |
| Last Update Date | 05/30/2023 |
| Medicare PECOS PAC ID | 8921289760 |
|---|---|
| Medicare Enrollment ID | O20110225000849 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073827101 | NPI | - | NPPES |
| 1073827101 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Dean Y Kim |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1215090832 PECOS PAC ID: 0143124636 Enrollment ID: I20031125000892 |
| Provider Name | Amanda Yancy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821003724 PECOS PAC ID: 0042114993 Enrollment ID: I20031126000693 |
| Provider Name | Gary E Galens |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487684585 PECOS PAC ID: 2961309943 Enrollment ID: I20031217000765 |
| Provider Name | Joseph M Hildebrand |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1841272754 PECOS PAC ID: 6406751122 Enrollment ID: I20031217000977 |
| Provider Name | Mahendra B Shah |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922193036 PECOS PAC ID: 4789582412 Enrollment ID: I20031219000457 |
| Provider Name | William Powell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881617322 PECOS PAC ID: 8820997471 Enrollment ID: I20040102000766 |
| Provider Name | Sujji N Potlapally |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427086032 PECOS PAC ID: 4385543875 Enrollment ID: I20040105000071 |
| Provider Name | Naveed Shaikh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720039514 PECOS PAC ID: 8820999253 Enrollment ID: I20040119000003 |
| Provider Name | Maciej R Uzieblo |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1508840315 PECOS PAC ID: 8224927595 Enrollment ID: I20040313000708 |
| Provider Name | Gerald M Hillman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568487510 PECOS PAC ID: 2668363680 Enrollment ID: I20040322000146 |
| Provider Name | Pano L Papalekas |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1174517304 PECOS PAC ID: 0749170900 Enrollment ID: I20040329001499 |
| Provider Name | Sam S Gabbara |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083709612 PECOS PAC ID: 7012909963 Enrollment ID: I20040331001096 |
| Provider Name | Imad Zak |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1093811697 PECOS PAC ID: 7719973379 Enrollment ID: I20040421000591 |
| Provider Name | Hsin Wang |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1114036787 PECOS PAC ID: 3072509132 Enrollment ID: I20040423000057 |
| Provider Name | Cheryl Grigorian |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750310397 PECOS PAC ID: 4981691680 Enrollment ID: I20040426001650 |
| Provider Name | Richard N Joyrich |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982638946 PECOS PAC ID: 5799773156 Enrollment ID: I20040504000929 |
| Provider Name | Victoria A Swegles |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942395827 PECOS PAC ID: 4284622655 Enrollment ID: I20040504000981 |
| Provider Name | Monte L Harvill |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942232129 PECOS PAC ID: 8527056936 Enrollment ID: I20040504001344 |
| Provider Name | Faysal A Saksouk |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750302311 PECOS PAC ID: 3870581812 Enrollment ID: I20040506000253 |
| Provider Name | Murali Guthikonda |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1780624239 PECOS PAC ID: 1153310784 Enrollment ID: I20040510000627 |
| Provider Name | Matthew J Wietrzykowski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528040979 PECOS PAC ID: 0345239513 Enrollment ID: I20040511001704 |
| Provider Name | Robert H Bixler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821095100 PECOS PAC ID: 5092796623 Enrollment ID: I20040528000854 |
| Provider Name | Barbara Levine-blase |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376523597 PECOS PAC ID: 3072596071 Enrollment ID: I20040610001098 |
| Provider Name | Sam Nasser |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1578500666 PECOS PAC ID: 0244139772 Enrollment ID: I20040611000636 |
| Provider Name | Robert E Meehan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1255379988 PECOS PAC ID: 0941283725 Enrollment ID: I20040611000659 |
| Provider Name | Mark Burnstein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992737712 PECOS PAC ID: 2567447840 Enrollment ID: I20040621001624 |
| Provider Name | Maysoon Al-hihi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1093741399 PECOS PAC ID: 8628053915 Enrollment ID: I20040621001734 |
| Provider Name | Steven R Hendrick |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1154391381 PECOS PAC ID: 4981689023 Enrollment ID: I20040622001114 |
| Provider Name | Sherryl D Hinton-scott |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1427014943 PECOS PAC ID: 3971588419 Enrollment ID: I20040623000193 |
| Provider Name | Omar Al-subee |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1194903708 PECOS PAC ID: 0143209478 Enrollment ID: I20040719001192 |
| Provider Name | Michael H Wood |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1144284670 PECOS PAC ID: 8022929538 Enrollment ID: I20040723000734 |
| Provider Name | Steven D Belen |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679564843 PECOS PAC ID: 6406826544 Enrollment ID: I20040727001479 |
| Provider Name | Atsushi Yoshida |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104989730 PECOS PAC ID: 0840264198 Enrollment ID: I20040823000738 |
| Provider Name | Troy L Sibson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1013925494 PECOS PAC ID: 3274507009 Enrollment ID: I20040825001451 |
| Provider Name | Steven Michael Zavinsky |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1134134919 PECOS PAC ID: 9537135124 Enrollment ID: I20040903001207 |
| Provider Name | Bryan E Little |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1134295504 PECOS PAC ID: 2264491539 Enrollment ID: I20041004000873 |
| Provider Name | Biren Ashok Shah |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952371429 PECOS PAC ID: 7214996792 Enrollment ID: I20041008001179 |
| Provider Name | Jose Antonio Bouffard |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043388788 PECOS PAC ID: 1759344500 Enrollment ID: I20041112000049 |
| Provider Name | Steven Dovitz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750351920 PECOS PAC ID: 9931186293 Enrollment ID: I20041129000193 |
| Provider Name | Alkis P Zingas |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366478513 PECOS PAC ID: 8527024603 Enrollment ID: I20041209000922 |
| Provider Name | Adil Yousif Arabbo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316936008 PECOS PAC ID: 2264480409 Enrollment ID: I20050105000173 |
| Provider Name | Robert A Teitge |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1801888714 PECOS PAC ID: 5698723385 Enrollment ID: I20050110000622 |
| Provider Name | Ronald Cheek |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1013957927 PECOS PAC ID: 0840240008 Enrollment ID: I20050125000938 |
| Provider Name | Richard G Krikorian |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700807104 PECOS PAC ID: 2062464803 Enrollment ID: I20050224000196 |
| Provider Name | Matthew C Rheinboldt |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1659449395 PECOS PAC ID: 3173437209 Enrollment ID: I20050615000379 |
| Provider Name | Nonie M Pokornicki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992919690 PECOS PAC ID: 0547298978 Enrollment ID: I20050727001105 |
| Provider Name | Rimma Aronov |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811068588 PECOS PAC ID: 0749219863 Enrollment ID: I20050809000964 |
| Provider Name | Shlomo Sam Mandel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952477325 PECOS PAC ID: 9436182458 Enrollment ID: I20050912000311 |
| Provider Name | Susan M Madden |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1679802425 PECOS PAC ID: 3678599164 Enrollment ID: I20051024000825 |
| Provider Name | Henry T Goitz |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1598831968 PECOS PAC ID: 3173425105 Enrollment ID: I20051024000972 |
| Provider Name | Deniz Altinok |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275569576 PECOS PAC ID: 8325065923 Enrollment ID: I20051101001074 |
| Provider Name | Mary Gordon Cornelius |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730190679 PECOS PAC ID: 5092732602 Enrollment ID: I20051101001130 |
| Provider Name | Ali Ahmad Bitar |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1447298526 PECOS PAC ID: 6406874486 Enrollment ID: I20051108000823 |
| Provider Name | Amal M Omran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144355934 PECOS PAC ID: 4284652231 Enrollment ID: I20051110000391 |
| Provider Name | Nathan Lawrence Gross |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1134174261 PECOS PAC ID: 6204855687 Enrollment ID: I20051115000572 |
| Provider Name | David Machnacki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982644803 PECOS PAC ID: 8123048386 Enrollment ID: I20051202000085 |
| Provider Name | Yogesh S Mody |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255354791 PECOS PAC ID: 8921020843 Enrollment ID: I20051220000568 |
| Provider Name | Lanetta A Coleman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1033150032 PECOS PAC ID: 4789607854 Enrollment ID: I20060104000801 |
| Provider Name | Safwan A Saker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417941477 PECOS PAC ID: 0042225526 Enrollment ID: I20060222000188 |
| Provider Name | Stephen Charles Schwartz |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1871580092 PECOS PAC ID: 6800804451 Enrollment ID: I20060323000702 |
| Provider Name | Douglas G Plagens |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1336249689 PECOS PAC ID: 1355359308 Enrollment ID: I20060403000094 |
| Provider Name | Richard Ohye |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1720170111 PECOS PAC ID: 4082623343 Enrollment ID: I20060413000504 |
| Provider Name | Robin A Hanks |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518904218 PECOS PAC ID: 5799797148 Enrollment ID: I20060629000120 |
| Provider Name | Stephen J Vangel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043257967 PECOS PAC ID: 9436161841 Enrollment ID: I20060630000105 |
| Provider Name | Jay Henry Kozlowski |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1689653669 PECOS PAC ID: 4486622347 Enrollment ID: I20060706000045 |
| Provider Name | Brent W Gillum |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659347821 PECOS PAC ID: 2264445196 Enrollment ID: I20060719000279 |
| Provider Name | Velji Karsan Kansara |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1831185693 PECOS PAC ID: 2163435959 Enrollment ID: I20060721000016 |
| Provider Name | Sampath Ramachandran |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528077567 PECOS PAC ID: 5395749642 Enrollment ID: I20060829000484 |
| Provider Name | Richard L Needleman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1265463178 PECOS PAC ID: 1153363460 Enrollment ID: I20060921000107 |
| Provider Name | Rahul Vaidya |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1932132958 PECOS PAC ID: 7416952395 Enrollment ID: I20060927000553 |
| Provider Name | Stephen E Lemos |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1740232792 PECOS PAC ID: 4385649276 Enrollment ID: I20060927000576 |
| Provider Name | Karen Joy Stanko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912004599 PECOS PAC ID: 5092711390 Enrollment ID: I20061010000365 |
| Provider Name | Kimberly D Wallace |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750327045 PECOS PAC ID: 9537168976 Enrollment ID: I20061212000221 |
| Provider Name | Rainna Furnari Brazil |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861489429 PECOS PAC ID: 2264432723 Enrollment ID: I20070105000418 |
| Provider Name | Anthony James Colucci |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1477523520 PECOS PAC ID: 0749184539 Enrollment ID: I20070125000558 |
| Provider Name | Santhosh Madhavan |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1124131479 PECOS PAC ID: 6507868536 Enrollment ID: I20070205000462 |
| Provider Name | Marley L Shook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588726897 PECOS PAC ID: 7214939511 Enrollment ID: I20070214000362 |
| Provider Name | Kerrie A Lucas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205916285 PECOS PAC ID: 3274635180 Enrollment ID: I20070223000394 |
| Provider Name | Ayoub Sayeg |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1780616359 PECOS PAC ID: 9234232935 Enrollment ID: I20070319000302 |
| Provider Name | Tanya E Sherman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104998731 PECOS PAC ID: 6305949173 Enrollment ID: I20070323000084 |
| Provider Name | Kiran Balchandani |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1932252145 PECOS PAC ID: 1355445115 Enrollment ID: I20070404000011 |
| Provider Name | Jacek R Brudzewski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720035850 PECOS PAC ID: 8325144686 Enrollment ID: I20070502000409 |
| Provider Name | Anthony Frank Harris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235207416 PECOS PAC ID: 0446356539 Enrollment ID: I20070507000410 |
| Provider Name | Scott Michael Silver |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1891998944 PECOS PAC ID: 4082715727 Enrollment ID: I20070724000666 |
| Provider Name | Adam Jay Folbe |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1346448040 PECOS PAC ID: 7618078122 Enrollment ID: I20070727000721 |
| Provider Name | Roja R Ramisetty |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1811019458 PECOS PAC ID: 5092816504 Enrollment ID: I20070727000796 |
| Provider Name | Beth C. Garretson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265552012 PECOS PAC ID: 8729189238 Enrollment ID: I20070727000799 |
| Provider Name | Ethan N Goldstein |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336357219 PECOS PAC ID: 4789777244 Enrollment ID: I20070829000837 |
| Provider Name | Eugene Kenneth Sawyer |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1467571133 PECOS PAC ID: 1052404779 Enrollment ID: I20070911000282 |
| Provider Name | Esmael H Amjad |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1851513857 PECOS PAC ID: 8123113560 Enrollment ID: I20071001000525 |
| Provider Name | Anthony D Williams |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1245246354 PECOS PAC ID: 5395830699 Enrollment ID: I20071002000261 |
| Provider Name | Cortney V Jones |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447452040 PECOS PAC ID: 0446346118 Enrollment ID: I20071011000507 |
| Provider Name | Aaron W Maddox |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235143777 PECOS PAC ID: 5698862498 Enrollment ID: I20071025000483 |
| Provider Name | Kelly A Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598754590 PECOS PAC ID: 1355438664 Enrollment ID: I20071102000704 |
| Provider Name | Sadiq Haque |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265649222 PECOS PAC ID: 7315035367 Enrollment ID: I20071108000665 |
| Provider Name | Katrina H Hobson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245350099 PECOS PAC ID: 9032207949 Enrollment ID: I20071109000566 |
| Provider Name | Lonnie F Joe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972657260 PECOS PAC ID: 5496843682 Enrollment ID: I20071126000163 |
| Provider Name | Walid K Yassir |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1447297551 PECOS PAC ID: 6305936519 Enrollment ID: I20071212000100 |
| Provider Name | Henry L Walters Iii |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1174503981 PECOS PAC ID: 8022115955 Enrollment ID: I20080514000440 |
| Provider Name | Ramotsami M Makhene |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1992866123 PECOS PAC ID: 5496825523 Enrollment ID: I20080602000537 |
| Provider Name | Monik Lala |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194847038 PECOS PAC ID: 9830264290 Enrollment ID: I20080819000766 |
| Provider Name | Yegappan Lakshmanan |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1881632388 PECOS PAC ID: 8527134329 Enrollment ID: I20080902000278 |
| Provider Name | Nivedita Dhar |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1346440526 PECOS PAC ID: 0345331500 Enrollment ID: I20080908000460 |
| Provider Name | Sonia Veronica Eden |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1518002070 PECOS PAC ID: 2769583400 Enrollment ID: I20081008000432 |
| Provider Name | Frank L Fenton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215081211 PECOS PAC ID: 8123012879 Enrollment ID: I20081009000296 |
| Provider Name | Robert L Dock |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1689645137 PECOS PAC ID: 2567402076 Enrollment ID: I20081120000211 |
| Provider Name | Anil Sethi |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1104019280 PECOS PAC ID: 0648330639 Enrollment ID: I20081120000553 |
| Provider Name | Karen L Braniff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750315370 PECOS PAC ID: 3678634508 Enrollment ID: I20081210000245 |
| Provider Name | Mary A Cameron |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780637876 PECOS PAC ID: 7719041409 Enrollment ID: I20090123000530 |
| Provider Name | Sheena Saleem |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174772909 PECOS PAC ID: 5698830461 Enrollment ID: I20090210000769 |
| Provider Name | Cheryl Moore |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861484289 PECOS PAC ID: 6507920063 Enrollment ID: I20090423000436 |
| Provider Name | David F Williams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710022017 PECOS PAC ID: 3173671302 Enrollment ID: I20090428000300 |
| Provider Name | Kristen L Richards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710143730 PECOS PAC ID: 3870642200 Enrollment ID: I20090514000248 |
| Provider Name | Yevgeniy Rits |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1083822753 PECOS PAC ID: 5991805541 Enrollment ID: I20090727000447 |
| Provider Name | Britta Margaret Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780704999 PECOS PAC ID: 6103972369 Enrollment ID: I20090914000481 |
| Provider Name | Bryant W Oliphant |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1679777353 PECOS PAC ID: 3375699887 Enrollment ID: I20090925000123 |
| Provider Name | Rita A Gatia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801122312 PECOS PAC ID: 6002958618 Enrollment ID: I20100120000520 |
| Provider Name | Mohammad T Kang |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1598904690 PECOS PAC ID: 5092859124 Enrollment ID: I20100212000469 |
| Provider Name | Najeeb F Zoubi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750395943 PECOS PAC ID: 6305971938 Enrollment ID: I20100320000217 |
| Provider Name | Dennis Treece |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679544852 PECOS PAC ID: 9335148741 Enrollment ID: I20100330001235 |
| Provider Name | Mark Aronov |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730390212 PECOS PAC ID: 0446381404 Enrollment ID: I20100708000597 |
| Provider Name | Ruth D Kozlowski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174598270 PECOS PAC ID: 3870625080 Enrollment ID: I20100722000714 |
| Provider Name | Dennis T Rafaill |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326013533 PECOS PAC ID: 2567405244 Enrollment ID: I20100722000779 |
| Provider Name | Philip A Lewalski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710928981 PECOS PAC ID: 1153453261 Enrollment ID: I20100723000925 |
| Provider Name | Jocelyn Mccrae |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023330776 PECOS PAC ID: 0941325310 Enrollment ID: I20100909000435 |
| Provider Name | Laurie Mancini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609199686 PECOS PAC ID: 7618092735 Enrollment ID: I20100914000089 |
| Provider Name | Mark D Mackey |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1003890187 PECOS PAC ID: 6002846888 Enrollment ID: I20101015000963 |
| Provider Name | Roland J Brandt |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1740271162 PECOS PAC ID: 3779572417 Enrollment ID: I20101101000680 |
| Provider Name | Jacqueline T Huynh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457382095 PECOS PAC ID: 4284660184 Enrollment ID: I20101102000813 |
| Provider Name | Daniel J Walz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144256256 PECOS PAC ID: 0042122574 Enrollment ID: I20101130001252 |
| Provider Name | Swati S Mody |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265455703 PECOS PAC ID: 8022198134 Enrollment ID: I20101203001237 |
| Provider Name | Ahmad Munir |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1730145228 PECOS PAC ID: 6103816772 Enrollment ID: I20110124001004 |
| Provider Name | An K Ang |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992753354 PECOS PAC ID: 1254355308 Enrollment ID: I20110207000769 |
| Provider Name | Michelle Dokas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518269034 PECOS PAC ID: 0042491565 Enrollment ID: I20110216000871 |
| Provider Name | Susan M Forest |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225358146 PECOS PAC ID: 5193906352 Enrollment ID: I20110221000797 |
| Provider Name | Muthanna L Louis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538359872 PECOS PAC ID: 8123201704 Enrollment ID: I20110318000458 |
| Provider Name | Diane L Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548577315 PECOS PAC ID: 3971787664 Enrollment ID: I20110404000704 |
| Provider Name | Larisa G Kovacevic |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063688760 PECOS PAC ID: 9133303605 Enrollment ID: I20110407000060 |
| Provider Name | Michael Majed Ajluni |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1851542807 PECOS PAC ID: 2860679081 Enrollment ID: I20110615000386 |
| Provider Name | Ali N Harb |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1588787808 PECOS PAC ID: 0143408195 Enrollment ID: I20110622000633 |
| Provider Name | Noah Stern |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1972727576 PECOS PAC ID: 0042498305 Enrollment ID: I20110711000227 |
| Provider Name | Hussein Darwiche |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1457528283 PECOS PAC ID: 8224221122 Enrollment ID: I20110714000135 |
| Provider Name | Conor Zuk |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629394119 PECOS PAC ID: 9537330600 Enrollment ID: I20110921000325 |
| Provider Name | Mazen Abdelhady |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1669771507 PECOS PAC ID: 5991977340 Enrollment ID: I20111007000592 |
| Provider Name | Suzanne Pasternak |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1912035817 PECOS PAC ID: 9739351859 Enrollment ID: I20111017000047 |
| Provider Name | Yash K Shah |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952496820 PECOS PAC ID: 1658451760 Enrollment ID: I20111027000774 |
| Provider Name | Shakir Hussein |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1609066455 PECOS PAC ID: 5395839575 Enrollment ID: I20111104000574 |
| Provider Name | Diana Rebecca Silas |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1528371929 PECOS PAC ID: 3870767031 Enrollment ID: I20111128000363 |
| Provider Name | Mark Upfal |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326175639 PECOS PAC ID: 7113191396 Enrollment ID: I20111128000545 |
| Provider Name | Jill A Meade |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407893902 PECOS PAC ID: 1658546551 Enrollment ID: I20111205000320 |
| Provider Name | Kunal Kalra |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1205015468 PECOS PAC ID: 8921166489 Enrollment ID: I20111213000833 |
| Provider Name | Kyle M Farr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144508904 PECOS PAC ID: 4183899339 Enrollment ID: I20111216000139 |
| Provider Name | Prasantha K Sarcar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720199912 PECOS PAC ID: 7012097124 Enrollment ID: I20111221000592 |
| Provider Name | Jeffrey M Zerin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366538001 PECOS PAC ID: 3274613385 Enrollment ID: I20120213000476 |
| Provider Name | Samuel C Johnson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891713186 PECOS PAC ID: 2466532569 Enrollment ID: I20120315000657 |
| Provider Name | Jennifer A Fleming |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225279797 PECOS PAC ID: 2466614524 Enrollment ID: I20120507000501 |
| Provider Name | Mazhar Hasan Khan |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1437462579 PECOS PAC ID: 0143122317 Enrollment ID: I20120606000262 |
| Provider Name | Bhavika Vinodkumar Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124309521 PECOS PAC ID: 3870758253 Enrollment ID: I20120710000568 |
| Provider Name | Ilka C Naumann |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1568620599 PECOS PAC ID: 4880872381 Enrollment ID: I20120725000705 |
| Provider Name | Roger K Kakos |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1578772687 PECOS PAC ID: 1254597628 Enrollment ID: I20120730000719 |
| Provider Name | Benjamin Rentfrow |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1962618751 PECOS PAC ID: 4880840867 Enrollment ID: I20120807000399 |
| Provider Name | Kristina D. Suson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508900267 PECOS PAC ID: 7416105135 Enrollment ID: I20120920000686 |
| Provider Name | Kristy Smith |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174752547 PECOS PAC ID: 8921257486 Enrollment ID: I20120927000607 |
| Provider Name | Brigid Waldron-perrine |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891041075 PECOS PAC ID: 1052561305 Enrollment ID: I20121022000491 |
| Provider Name | Donna Bednarski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346369238 PECOS PAC ID: 9739331067 Enrollment ID: I20121212000313 |
| Provider Name | Andria Scappaticci Hazergian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053662981 PECOS PAC ID: 7911150370 Enrollment ID: I20130115000052 |
| Provider Name | Cari S Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033438668 PECOS PAC ID: 1153574249 Enrollment ID: I20130124000225 |
| Provider Name | Monzer M Saad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609009778 PECOS PAC ID: 6406000215 Enrollment ID: I20130202000030 |
| Provider Name | Samantha M Dewan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568784379 PECOS PAC ID: 2264686542 Enrollment ID: I20130214000398 |
| Provider Name | Margaret Clare Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124306212 PECOS PAC ID: 0345495685 Enrollment ID: I20130312000502 |
| Provider Name | Katherine M Metcalf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669439758 PECOS PAC ID: 2668485129 Enrollment ID: I20130328000494 |
| Provider Name | Sambasiva R Bathula |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1013223239 PECOS PAC ID: 8527204817 Enrollment ID: I20130410000512 |
| Provider Name | James P Valenti |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1164775318 PECOS PAC ID: 8729224845 Enrollment ID: I20130416000505 |
| Provider Name | Shanette L Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679815203 PECOS PAC ID: 2961640917 Enrollment ID: I20130603000310 |
| Provider Name | Angela Bowman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629329032 PECOS PAC ID: 7113166562 Enrollment ID: I20130617000304 |
| Provider Name | Bani Preet Kaur |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346544392 PECOS PAC ID: 6002057452 Enrollment ID: I20130726000470 |
| Provider Name | Bethany Wickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518087352 PECOS PAC ID: 6002054798 Enrollment ID: I20130812000707 |
| Provider Name | Jonathan N Warner |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1437360757 PECOS PAC ID: 3476611294 Enrollment ID: I20130909000501 |
| Provider Name | Rachel Allison O'keefe |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134357288 PECOS PAC ID: 2860626652 Enrollment ID: I20131010000624 |
| Provider Name | Kenneth J Early |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154664753 PECOS PAC ID: 7911131487 Enrollment ID: I20131016001377 |
| Provider Name | Tara Yvette Lindsey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1528297355 PECOS PAC ID: 6608001920 Enrollment ID: I20131022001897 |
| Provider Name | Hope Marie Gregory |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912348244 PECOS PAC ID: 7416182472 Enrollment ID: I20131028001809 |
| Provider Name | Ahmed A Bazzi |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1497913743 PECOS PAC ID: 1850556051 Enrollment ID: I20131101000844 |
| Provider Name | Zaid W Abu-seir |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1285898536 PECOS PAC ID: 0547496093 Enrollment ID: I20131112000568 |
| Provider Name | Amaan A Haq |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275853269 PECOS PAC ID: 7113155490 Enrollment ID: I20140113000968 |
| Provider Name | Katherine M Greening |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1710311048 PECOS PAC ID: 3375773690 Enrollment ID: I20140307000191 |
| Provider Name | Samara Gibson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770712176 PECOS PAC ID: 7911130091 Enrollment ID: I20140424001741 |
| Provider Name | Mahmoud Sabbagh |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1770898090 PECOS PAC ID: 7719100874 Enrollment ID: I20140519002242 |
| Provider Name | Devone T Mansour |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1932549797 PECOS PAC ID: 5597999581 Enrollment ID: I20140625001532 |
| Provider Name | Aziz A Alkatib |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1043417926 PECOS PAC ID: 8426116005 Enrollment ID: I20140714000876 |
| Provider Name | Madeleine Charlson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417383613 PECOS PAC ID: 6204054612 Enrollment ID: I20140827000711 |
| Provider Name | Kerellos A Nasr |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1114236171 PECOS PAC ID: 9830317163 Enrollment ID: I20140828002230 |
| Provider Name | Jonathan K Nzoma |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1417257551 PECOS PAC ID: 3173741048 Enrollment ID: I20140908000259 |
| Provider Name | Joshua D Hoover |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073914214 PECOS PAC ID: 2860611803 Enrollment ID: I20140924000603 |
| Provider Name | David Hassan Rustom |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1073877320 PECOS PAC ID: 5890915193 Enrollment ID: I20141009000788 |
| Provider Name | Heather Lochner |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1376718700 PECOS PAC ID: 9032276282 Enrollment ID: I20141030000515 |
| Provider Name | Jaclyn Carol House |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700289543 PECOS PAC ID: 1355667098 Enrollment ID: I20150224001065 |
| Provider Name | Kimberly Darlene Eadie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952630451 PECOS PAC ID: 5991021420 Enrollment ID: I20150227001647 |
| Provider Name | Cynthera Mcneill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770904831 PECOS PAC ID: 9931429651 Enrollment ID: I20150520002550 |
| Provider Name | Tony Abood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194165829 PECOS PAC ID: 9931429206 Enrollment ID: I20150528000582 |
| Provider Name | Nicole N Sovey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063810216 PECOS PAC ID: 5991026536 Enrollment ID: I20150608001009 |
| Provider Name | Bensson V Samuel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710240403 PECOS PAC ID: 5991018053 Enrollment ID: I20150717001563 |
| Provider Name | Mary Ibe |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1326168188 PECOS PAC ID: 5092028670 Enrollment ID: I20150727000424 |
| Provider Name | Nathan Gonik |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1174759815 PECOS PAC ID: 9638483209 Enrollment ID: I20150728003818 |
| Provider Name | Faesal E Elbakoush |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336545417 PECOS PAC ID: 1355655705 Enrollment ID: I20150730010790 |
| Provider Name | Sandra M Sawicki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588687818 PECOS PAC ID: 4688988306 Enrollment ID: I20150807014786 |
| Provider Name | Nicholas J Moore |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1265727556 PECOS PAC ID: 1658687041 Enrollment ID: I20150831001949 |
| Provider Name | Bianca Siegel |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1467684555 PECOS PAC ID: 4587972237 Enrollment ID: I20150930001776 |
| Provider Name | Omar Soto-aviles |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1447480645 PECOS PAC ID: 7416265061 Enrollment ID: I20150930002102 |
| Provider Name | Mekasha Mikael Getachew |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619988847 PECOS PAC ID: 8325015381 Enrollment ID: I20151008000622 |
| Provider Name | Tamara Lynn Wyscaver Dirven |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780944538 PECOS PAC ID: 7113227372 Enrollment ID: I20151120000406 |
| Provider Name | Jason A Rolls |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245497478 PECOS PAC ID: 0547324071 Enrollment ID: I20151120000432 |
| Provider Name | Ali Younes Makki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417235227 PECOS PAC ID: 4981904059 Enrollment ID: I20151120001122 |
| Provider Name | Nicole Ann Gagliardi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164898722 PECOS PAC ID: 6305146457 Enrollment ID: I20151123001011 |
| Provider Name | Donald Lawson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003247826 PECOS PAC ID: 2769782820 Enrollment ID: I20151123001356 |
| Provider Name | Brigitte M Berryhill |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114239050 PECOS PAC ID: 7517268154 Enrollment ID: I20151223001640 |
| Provider Name | Shilpa Jain |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477866572 PECOS PAC ID: 8628373214 Enrollment ID: I20160218002054 |
| Provider Name | Sheral B Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023493988 PECOS PAC ID: 0345545778 Enrollment ID: I20160223002749 |
| Provider Name | Andrew Thomas Berwick |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457794836 PECOS PAC ID: 4587965025 Enrollment ID: I20160627000343 |
| Provider Name | Emily J Ren |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1205128931 PECOS PAC ID: 2163727389 Enrollment ID: I20160712000478 |
| Provider Name | Marian Mocanu |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1770768038 PECOS PAC ID: 4385784602 Enrollment ID: I20160719001465 |
| Provider Name | Shaheen Alanee |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1326231390 PECOS PAC ID: 6800051582 Enrollment ID: I20160719001717 |
| Provider Name | Michelene Cindy Liebman |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1700063310 PECOS PAC ID: 9638215759 Enrollment ID: I20160727001061 |
| Provider Name | Petra J Gheraibeh |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1518014331 PECOS PAC ID: 3779757315 Enrollment ID: I20160728001650 |
| Provider Name | Peter Sassalos |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1780703090 PECOS PAC ID: 9931416435 Enrollment ID: I20160803000899 |
| Provider Name | Fatin Sahhar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518213842 PECOS PAC ID: 4385938372 Enrollment ID: I20160815001455 |
| Provider Name | Summar Habib Reslan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831550383 PECOS PAC ID: 5092009985 Enrollment ID: I20160816002149 |
| Provider Name | Jeremy Ryan Ciullo |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1265660062 PECOS PAC ID: 9436444676 Enrollment ID: I20160826000393 |
| Provider Name | Abubaker Ali |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1063640068 PECOS PAC ID: 3678887676 Enrollment ID: I20160909000219 |
| Provider Name | Amity Bates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154780591 PECOS PAC ID: 6507153632 Enrollment ID: I20160916002358 |
| Provider Name | Anna Miller |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427031095 PECOS PAC ID: 8921084294 Enrollment ID: I20160919000543 |
| Provider Name | Erin Marie Suminski |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1598214785 PECOS PAC ID: 5395033039 Enrollment ID: I20161012000448 |
| Provider Name | Brandon S Kakos |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1366677437 PECOS PAC ID: 5991946857 Enrollment ID: I20161103000893 |
| Provider Name | Stephanie Cole |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1922238666 PECOS PAC ID: 1456577014 Enrollment ID: I20161111001158 |
| Provider Name | Janae Preece |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1922233683 PECOS PAC ID: 4587944897 Enrollment ID: I20161202001059 |
| Provider Name | Xhoana Kociaj |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801338173 PECOS PAC ID: 1658651971 Enrollment ID: I20161202001165 |
| Provider Name | Donyelle Pavonne Moore-baldwin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093026262 PECOS PAC ID: 3274835368 Enrollment ID: I20161212002166 |
| Provider Name | Gulcin Altinok |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164734547 PECOS PAC ID: 7719299478 Enrollment ID: I20161214000440 |
| Provider Name | Ahmed M El-sabbagh |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1376917781 PECOS PAC ID: 0941502488 Enrollment ID: I20170224000488 |
| Provider Name | Dianna Ehlert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336695923 PECOS PAC ID: 1850676180 Enrollment ID: I20170328001973 |
| Provider Name | Marisa L Smitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689058463 PECOS PAC ID: 6305152836 Enrollment ID: I20170420000154 |
| Provider Name | Lydia Mayida |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992921894 PECOS PAC ID: 4981883139 Enrollment ID: I20170428001409 |
| Provider Name | Chirstopher Grady Minnock |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1689962342 PECOS PAC ID: 6507177698 Enrollment ID: I20170622000406 |
| Provider Name | Scott J Baker |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073807293 PECOS PAC ID: 9537439930 Enrollment ID: I20170718001317 |
| Provider Name | Christopher Lee Cooke |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1487934824 PECOS PAC ID: 7315232535 Enrollment ID: I20170718001707 |
| Provider Name | Fady S Yasso |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851719991 PECOS PAC ID: 0345541249 Enrollment ID: I20170719001233 |
| Provider Name | Erin Marie Fiore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467982470 PECOS PAC ID: 6901177815 Enrollment ID: I20170810000691 |
| Provider Name | Mallory O Niel |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1528357506 PECOS PAC ID: 8123347945 Enrollment ID: I20170810002658 |
| Provider Name | Marwah Mazin Hussein |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548657729 PECOS PAC ID: 3870896954 Enrollment ID: I20170816000746 |
| Provider Name | Ali Luqman |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1386877736 PECOS PAC ID: 9830413459 Enrollment ID: I20170816001643 |
| Provider Name | Marc Moisi |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1104078617 PECOS PAC ID: 7719205343 Enrollment ID: I20170816002115 |
| Provider Name | Khaled Meloud Sleik |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1033221056 PECOS PAC ID: 9234117722 Enrollment ID: I20170822001950 |
| Provider Name | Barrett Gilchrist Anderson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1972735587 PECOS PAC ID: 8729396569 Enrollment ID: I20170823001480 |
| Provider Name | Steven N Rives |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982944666 PECOS PAC ID: 3476825456 Enrollment ID: I20170825002093 |
| Provider Name | Zaher Hakim |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1306191853 PECOS PAC ID: 8325349012 Enrollment ID: I20171002001677 |
| Provider Name | Gary Anthony Forgach |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1639411747 PECOS PAC ID: 0749581403 Enrollment ID: I20171012002688 |
| Provider Name | Kristine K Hay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588186118 PECOS PAC ID: 3375818552 Enrollment ID: I20171016000141 |
| Provider Name | Madhumitha Krishnamoorthy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124438445 PECOS PAC ID: 0840581559 Enrollment ID: I20171107000196 |
| Provider Name | Jennifer Lynn Pelshaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316492283 PECOS PAC ID: 5496012817 Enrollment ID: I20171120002045 |
| Provider Name | Amanda Ryan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366897696 PECOS PAC ID: 1254698681 Enrollment ID: I20171120002323 |
| Provider Name | Tara L Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629494422 PECOS PAC ID: 7911264254 Enrollment ID: I20171122000420 |
| Provider Name | Aldo C Ruffolo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235124561 PECOS PAC ID: 1951339142 Enrollment ID: I20171129000385 |
| Provider Name | Gurmeet Kaur Gogia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902311525 PECOS PAC ID: 0345500880 Enrollment ID: I20180201001951 |
| Provider Name | Marie Chris Eamon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952770380 PECOS PAC ID: 4385940246 Enrollment ID: I20180206001395 |
| Provider Name | Jessie Poisson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952819880 PECOS PAC ID: 7618230053 Enrollment ID: I20180417000898 |
| Provider Name | Rachel E Keelan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427553007 PECOS PAC ID: 7416211164 Enrollment ID: I20180503001697 |
| Provider Name | Foaz Kayali |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1871882365 PECOS PAC ID: 5597020354 Enrollment ID: I20180525001147 |
| Provider Name | Lisa May Mercier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699271775 PECOS PAC ID: 6002171444 Enrollment ID: I20180605002904 |
| Provider Name | Rojy Thomas Philip |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366838153 PECOS PAC ID: 8820213515 Enrollment ID: I20180626003496 |
| Provider Name | Andrew John Ketner |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1043574874 PECOS PAC ID: 8224271648 Enrollment ID: I20180710001532 |
| Provider Name | Garret Justin Holcomb |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679987549 PECOS PAC ID: 8628371903 Enrollment ID: I20180712002861 |
| Provider Name | Ghaith Alhatemi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851787048 PECOS PAC ID: 6204139033 Enrollment ID: I20180718000905 |
| Provider Name | Malgorzata Baumann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578050134 PECOS PAC ID: 7517214844 Enrollment ID: I20180718001763 |
| Provider Name | Todor Toromanovski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801237847 PECOS PAC ID: 6901125160 Enrollment ID: I20180807003442 |
| Provider Name | John V Morasso |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1639583206 PECOS PAC ID: 8527353374 Enrollment ID: I20180824000607 |
| Provider Name | Michael A Bush-arnold |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1740600675 PECOS PAC ID: 7719280759 Enrollment ID: I20180904000817 |
| Provider Name | William D Rusinow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295118784 PECOS PAC ID: 4688964547 Enrollment ID: I20181009001856 |
| Provider Name | Andrew Guan-hao Tsai |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1629367982 PECOS PAC ID: 1658649298 Enrollment ID: I20181016001340 |
| Provider Name | Hani H Abujudeh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992793756 PECOS PAC ID: 1759343809 Enrollment ID: I20181025002790 |
| Provider Name | Jasmine Singh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235642919 PECOS PAC ID: 0042564585 Enrollment ID: I20181119002864 |
| Provider Name | Asia Maxine Bradley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821437211 PECOS PAC ID: 9931425139 Enrollment ID: I20181120000654 |
| Provider Name | Raya Kutaimy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821484122 PECOS PAC ID: 6103123047 Enrollment ID: I20181120003271 |
| Provider Name | Obiageri Rita Opara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114423514 PECOS PAC ID: 4981948395 Enrollment ID: I20181211002526 |
| Provider Name | Christopher Ernest Childers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851866396 PECOS PAC ID: 2668717018 Enrollment ID: I20181213000910 |
| Provider Name | Charlton Castillo Lacerna |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235373135 PECOS PAC ID: 2365694775 Enrollment ID: I20181213001264 |
| Provider Name | Joan Frances Benedetti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437315660 PECOS PAC ID: 4789929092 Enrollment ID: I20181214000472 |
| Provider Name | Sara Muer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669955753 PECOS PAC ID: 3678818986 Enrollment ID: I20181214000516 |
| Provider Name | Kacee Anne Harris-jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104301910 PECOS PAC ID: 1052656832 Enrollment ID: I20181226000579 |
| Provider Name | Robert D Rothermel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275571390 PECOS PAC ID: 5193060655 Enrollment ID: I20190103000093 |
| Provider Name | Jean Marie Kindermann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992271985 PECOS PAC ID: 2365788791 Enrollment ID: I20190107001200 |
| Provider Name | Cecilia Canto Helwig |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1528258787 PECOS PAC ID: 3375635436 Enrollment ID: I20190110000805 |
| Provider Name | Parthasarathi Chamiraju |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1184973729 PECOS PAC ID: 2769783539 Enrollment ID: I20190110003532 |
| Provider Name | Ileana Livia Pina |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1144240771 PECOS PAC ID: 9032205422 Enrollment ID: I20190111001653 |
| Provider Name | Natakki Wheatley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225423031 PECOS PAC ID: 0042581159 Enrollment ID: I20190225003100 |
| Provider Name | Lindsey Webb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982168050 PECOS PAC ID: 7012256183 Enrollment ID: I20190307000888 |
| Provider Name | Zhen Wu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194017970 PECOS PAC ID: 8022316322 Enrollment ID: I20190313000718 |
| Provider Name | Kristian Loveridge |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487079778 PECOS PAC ID: 7416258306 Enrollment ID: I20190404000258 |
| Provider Name | Sheeja Xavier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417415498 PECOS PAC ID: 9436490794 Enrollment ID: I20190415001120 |
| Provider Name | Ahmad A Maqboul |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306272372 PECOS PAC ID: 4981986171 Enrollment ID: I20190502000638 |
| Provider Name | Shane Norman Newberger |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700134731 PECOS PAC ID: 7315289584 Enrollment ID: I20190508003398 |
| Provider Name | Kenton James Zehr |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1548248354 PECOS PAC ID: 6608885009 Enrollment ID: I20190514002655 |
| Provider Name | M. Chadi Alraies |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1689828238 PECOS PAC ID: 9537222997 Enrollment ID: I20190619002237 |
| Provider Name | Kartik Kumar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356736912 PECOS PAC ID: 8224330097 Enrollment ID: I20190625003783 |
| Provider Name | Abeer Berry |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1003254798 PECOS PAC ID: 0547491292 Enrollment ID: I20190716003230 |
| Provider Name | Shima Aran |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417361304 PECOS PAC ID: 1951528066 Enrollment ID: I20190723001011 |
| Provider Name | James Davis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346688181 PECOS PAC ID: 9436389632 Enrollment ID: I20190808002306 |
| Provider Name | Yusuke Terasaki |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1437473188 PECOS PAC ID: 6406164979 Enrollment ID: I20190816000404 |
| Provider Name | Jacquelyn Marie Avery |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952705170 PECOS PAC ID: 2567790462 Enrollment ID: I20190829002171 |
| Provider Name | Raja A Rabadi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265815476 PECOS PAC ID: 5395025464 Enrollment ID: I20190829002211 |
| Provider Name | Anna Leigh Swoboda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407236615 PECOS PAC ID: 0840585162 Enrollment ID: I20190829002283 |
| Provider Name | Lauren Renee Uroda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841687894 PECOS PAC ID: 1951603992 Enrollment ID: I20191004000437 |
| Provider Name | Leila Ettefagh |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1861887911 PECOS PAC ID: 7719218874 Enrollment ID: I20191004000443 |
| Provider Name | Steven R Slotkin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1780926816 PECOS PAC ID: 9133351927 Enrollment ID: I20191004000639 |
| Provider Name | Nicole Henriksen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255675005 PECOS PAC ID: 4789915869 Enrollment ID: I20191004001041 |
| Provider Name | Shivani Agrawal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770922296 PECOS PAC ID: 8729217351 Enrollment ID: I20191004001094 |
| Provider Name | Brittany N Hedrick |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1518305556 PECOS PAC ID: 3476782616 Enrollment ID: I20191011002108 |
| Provider Name | Aldo Nunez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861877730 PECOS PAC ID: 2769713387 Enrollment ID: I20191014001149 |
| Provider Name | Melanie Schwiesow |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1689091878 PECOS PAC ID: 2567751639 Enrollment ID: I20191015001416 |
| Provider Name | Kaushik Mandal |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1982851028 PECOS PAC ID: 4385822808 Enrollment ID: I20191031001572 |
| Provider Name | Ashneal Sharma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164895801 PECOS PAC ID: 9537413661 Enrollment ID: I20191101001193 |
| Provider Name | Brandi Miller |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1932463940 PECOS PAC ID: 3072747344 Enrollment ID: I20200116003009 |
| Provider Name | Daniel Peisach |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902226103 PECOS PAC ID: 7719312784 Enrollment ID: I20200121002587 |
| Provider Name | Nicole Caraballo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871803247 PECOS PAC ID: 8426484387 Enrollment ID: I20200212002538 |
| Provider Name | Erin Marie Hamel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689173767 PECOS PAC ID: 7012345408 Enrollment ID: I20200318001083 |
| Provider Name | Erin Mccarty |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1487093357 PECOS PAC ID: 9436388477 Enrollment ID: I20200526002502 |
| Provider Name | Raji George |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215590674 PECOS PAC ID: 5496176323 Enrollment ID: I20200602001285 |
| Provider Name | Ralph K. Ariss |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902224637 PECOS PAC ID: 0648574186 Enrollment ID: I20200610002699 |
| Provider Name | Scott Allen Mccarty |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1558789008 PECOS PAC ID: 7810299575 Enrollment ID: I20200626002185 |
| Provider Name | Matthew Mckenna |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992225882 PECOS PAC ID: 4981973567 Enrollment ID: I20200629003106 |
| Provider Name | Tyler D Williamson |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1811379068 PECOS PAC ID: 4082988050 Enrollment ID: I20200701002708 |
| Provider Name | Mohamed Zghouzi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275897993 PECOS PAC ID: 6305153818 Enrollment ID: I20200723003770 |
| Provider Name | Chase Ansok |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1629496237 PECOS PAC ID: 9537385711 Enrollment ID: I20200724001402 |
| Provider Name | Amy E Somerset |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1790124303 PECOS PAC ID: 1557593548 Enrollment ID: I20200825002318 |
| Provider Name | Manuel Schubert |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1598176471 PECOS PAC ID: 0941525687 Enrollment ID: I20200828001482 |
| Provider Name | Carissa Wentland |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1558682815 PECOS PAC ID: 9739409905 Enrollment ID: I20200828001563 |
| Provider Name | Samantha Mulkiten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801407119 PECOS PAC ID: 3476970963 Enrollment ID: I20200828001612 |
| Provider Name | Melissa Wiseheart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851904684 PECOS PAC ID: 6507284312 Enrollment ID: I20200910002378 |
| Provider Name | Deborah S Tyler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134514458 PECOS PAC ID: 2668784505 Enrollment ID: I20200914000308 |
| Provider Name | Mamdouh Dakhel A Alahmadi |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1164037735 PECOS PAC ID: 6800215237 Enrollment ID: I20201002002197 |
| Provider Name | Ashley Mary Asmar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558976928 PECOS PAC ID: 4385064401 Enrollment ID: I20201012001068 |
| Provider Name | Matthew T Maraman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962960518 PECOS PAC ID: 2961822432 Enrollment ID: I20201022000506 |
| Provider Name | Lauren Marchese |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174043459 PECOS PAC ID: 8921377714 Enrollment ID: I20201204000706 |
| Provider Name | Adriane Marchese |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265952543 PECOS PAC ID: 3476822263 Enrollment ID: I20201204000885 |
| Provider Name | Ali Bazzy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730602004 PECOS PAC ID: 4385055870 Enrollment ID: I20201207000354 |
| Provider Name | Chiu Yuen To |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1861794000 PECOS PAC ID: 9032398714 Enrollment ID: I20201207002487 |
| Provider Name | Kelley Lynne Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790322576 PECOS PAC ID: 6406260017 Enrollment ID: I20210121003152 |
| Provider Name | Amela Hrnic Montalvo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346698495 PECOS PAC ID: 5496161143 Enrollment ID: I20210304001551 |
| Provider Name | Jennifer Malagari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760084420 PECOS PAC ID: 2365841780 Enrollment ID: I20210604000107 |
| Provider Name | Jorge Alchammas |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679953996 PECOS PAC ID: 3971812777 Enrollment ID: I20210609000658 |
| Provider Name | Ramya Vadlamudi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710249727 PECOS PAC ID: 1254640931 Enrollment ID: I20210611001150 |
| Provider Name | Mykol Larvie |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215907639 PECOS PAC ID: 2062583453 Enrollment ID: I20210625001074 |
| Provider Name | Gregory Mlacker |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205219904 PECOS PAC ID: 9931530961 Enrollment ID: I20210629000524 |
| Provider Name | Brandon M Mansoor |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174905632 PECOS PAC ID: 0042529869 Enrollment ID: I20210706000762 |
| Provider Name | Tagwa Khairalseed |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801201090 PECOS PAC ID: 2163720129 Enrollment ID: I20210720000890 |
| Provider Name | Nabeel Rizvi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104273879 PECOS PAC ID: 3870885759 Enrollment ID: I20210907000482 |
| Provider Name | Nicholas Onyeador |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679918676 PECOS PAC ID: 0345535241 Enrollment ID: I20210914000514 |
| Provider Name | Harold Obiakor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598157794 PECOS PAC ID: 9537461066 Enrollment ID: I20211005001253 |
| Provider Name | Amanda Zwilling |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760146104 PECOS PAC ID: 9335537711 Enrollment ID: I20211104001280 |
| Provider Name | Madison Marie Phee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831769348 PECOS PAC ID: 6800285263 Enrollment ID: I20211105001894 |
| Provider Name | Megan Elizabeth Sharo |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1295300853 PECOS PAC ID: 0345630505 Enrollment ID: I20211201002088 |
| Provider Name | Marcus Macdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194471763 PECOS PAC ID: 3577957943 Enrollment ID: I20220301000573 |
| Provider Name | Megan Blanche Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073262853 PECOS PAC ID: 7517345416 Enrollment ID: I20220606001675 |
| Provider Name | Angel Hairston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013665322 PECOS PAC ID: 0749660280 Enrollment ID: I20220630001381 |
| Provider Name | Samarth Dhawan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407351463 PECOS PAC ID: 7618357153 Enrollment ID: I20220630001507 |
| Provider Name | Christine Paniti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962049759 PECOS PAC ID: 3678953130 Enrollment ID: I20220630002110 |
| Provider Name | Hunter L Ross |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1649790494 PECOS PAC ID: 7012286875 Enrollment ID: I20220705001990 |
| Provider Name | Alexander Alan Turfe |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1457883878 PECOS PAC ID: 1557631454 Enrollment ID: I20220805002609 |
| Provider Name | Lakisha Franklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588315758 PECOS PAC ID: 6103208178 Enrollment ID: I20220808001895 |
| Provider Name | Joshua L Gatz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770080806 PECOS PAC ID: 0840545562 Enrollment ID: I20220809000869 |
| Provider Name | Sheri N Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407419856 PECOS PAC ID: 8426431214 Enrollment ID: I20220811000407 |
| Provider Name | Sun H Kim |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1457766958 PECOS PAC ID: 9739494311 Enrollment ID: I20220812000302 |
| Provider Name | George Sebastian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467940882 PECOS PAC ID: 8527301845 Enrollment ID: I20220815001006 |
| Provider Name | Michael Lucas Perry |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1457745564 PECOS PAC ID: 2668773805 Enrollment ID: I20220816000685 |
| Provider Name | Mahmood M Alasmi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215120126 PECOS PAC ID: 3375607450 Enrollment ID: I20220825003253 |
| Provider Name | Musa Hazemy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124761275 PECOS PAC ID: 7214303064 Enrollment ID: I20221019000490 |
| Provider Name | Sowmya Angusamy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295085967 PECOS PAC ID: 1254707987 Enrollment ID: I20221020000169 |
| Provider Name | Adel A Roshdi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265569578 PECOS PAC ID: 6204206865 Enrollment ID: I20221224000029 |
| Provider Name | Mahmoud Anteet |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225485634 PECOS PAC ID: 5799072021 Enrollment ID: I20230505001692 |
| Provider Name | Zeinab Bazzi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1346701745 PECOS PAC ID: 4183951577 Enrollment ID: I20230517000175 |
| Provider Name | Cristina Coccia Galvan |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1992335152 PECOS PAC ID: 7416315627 Enrollment ID: I20230621000815 |
| Provider Name | Cole Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144912387 PECOS PAC ID: 9931567807 Enrollment ID: I20230626000296 |
| Provider Name | Tarek Makki |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1750709572 PECOS PAC ID: 0042511081 Enrollment ID: I20230626000996 |
| Provider Name | Mary Reid |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205490224 PECOS PAC ID: 5698009579 Enrollment ID: I20230728001986 |
| Provider Name | Radomir Dimovski |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1518490861 PECOS PAC ID: 7214205582 Enrollment ID: I20230807003843 |
| Provider Name | Sasha Stine |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1700380862 PECOS PAC ID: 6305101569 Enrollment ID: I20230815003398 |
| Provider Name | Kelsey Baker |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1346803889 PECOS PAC ID: 0042544199 Enrollment ID: I20230828001481 |
| Provider Name | Lauren Roberts |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144885997 PECOS PAC ID: 0446588032 Enrollment ID: I20230909000228 |
| Provider Name | Keith Samuel Mcarthur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841975828 PECOS PAC ID: 3779937537 Enrollment ID: I20230927002283 |
| Provider Name | David Alex Hamilton |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1154853356 PECOS PAC ID: 8729355706 Enrollment ID: I20231003001392 |
| Provider Name | Sawsan Hashwi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275238552 PECOS PAC ID: 0244670875 Enrollment ID: I20240430003090 |
| Provider Name | Andrew Goschka |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508217969 PECOS PAC ID: 8628311693 Enrollment ID: I20240520002591 |
| Provider Name | Andrew Sham Gupta |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1639430556 PECOS PAC ID: 6800198045 Enrollment ID: I20240613002038 |
Med-share, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 26222 Telegraph Rd, Suite 100, Southfield, MI 48033 Phone: 248-827-7200 Fax: 248-827-2641 | |
Caring Doctors At Home Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 29600 Northwestern Highway, Suite 106, Southfield, MI 48034 Phone: 313-258-4855 | |
Maecenas Health Systems Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 26677 W 12 Mile Rd, Southfield, MI 48034 Phone: 248-358-6995 | |
Ark Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 23999 Northwestern Hwy, Southfield, MI 48075 Phone: 248-924-1429 Fax: 248-419-2431 | |
Laina Feinstein Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 29829 Telegraph Rd, Suite 107, Southfield, MI 48034 Phone: 248-304-0786 Fax: 248-354-8559 | |
Magnum Managment Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17600 W 8 Mile Rd, Suite # 5, Southfield, MI 48075 Phone: 248-424-9749 | |
American Current Care Of Michigan, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 26185 Greenfield Rd, Southfield, MI 48076 Phone: 248-569-2040 Fax: 248-569-2048 |