| Gwinnett Physician Group, Llc | |
|
1000 Medical Center Blvd Mob 100 Suite 210 Lawrenceville GA 30046-7694 | |
| (855) 709-4535 | |
| (770) 339-2120 |
| Full Name | Gwinnett Physician Group, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1000 Medical Center Blvd, Lawrenceville, Georgia |
| Authorized Official Name and Position | Jorge Hernandez (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4048516378 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gwinnett Physician Group, Llc 1000 Johnson Ferry Road, Ne Attn: Jorge Hernandez Atlanta GA 30342 Ph: (404) 851-6378 | Gwinnett Physician Group, Llc 1000 Medical Center Blvd Mob 100 Suite 210 Lawrenceville GA 30046-7694 Ph: (855) 709-4535 |
| NPI Number | 1578574661 |
|---|---|
| Provider Enumeration Date | 08/11/2006 |
| Last Update Date | 01/11/2023 |
| Medicare PECOS PAC ID | 9133211139 |
|---|---|
| Medicare Enrollment ID | O20070822001035 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578574661 | NPI | - | NPPES |
| Provider Name | David J Najjar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467668210 PECOS PAC ID: 2466364765 Enrollment ID: I20031110000461 |
| Provider Name | Kenneth Kalassian |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1700897048 PECOS PAC ID: 3173417292 Enrollment ID: I20040210000944 |
| Provider Name | James M Adkins |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1508811373 PECOS PAC ID: 4284624990 Enrollment ID: I20040514000733 |
| Provider Name | Peter J Kaplan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1942203757 PECOS PAC ID: 7618959263 Enrollment ID: I20040607000401 |
| Provider Name | Lisa F. Fowlkes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871504100 PECOS PAC ID: 7810971652 Enrollment ID: I20040617000857 |
| Provider Name | Peter C Mann |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730179805 PECOS PAC ID: 7012810617 Enrollment ID: I20040624000166 |
| Provider Name | Neeta D Sukthanker |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1790711265 PECOS PAC ID: 5991782740 Enrollment ID: I20040630000734 |
| Provider Name | Lori A Parker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124099403 PECOS PAC ID: 4789654419 Enrollment ID: I20040729000350 |
| Provider Name | Michael R Munsey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356362826 PECOS PAC ID: 1355314584 Enrollment ID: I20040817000182 |
| Provider Name | James S Lee |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1366593154 PECOS PAC ID: 6204801863 Enrollment ID: I20040827000969 |
| Provider Name | Natacha Simon-christie |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1376598169 PECOS PAC ID: 7315915196 Enrollment ID: I20040920000755 |
| Provider Name | Shivani Bhatia |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1427003672 PECOS PAC ID: 9537069349 Enrollment ID: I20040928000780 |
| Provider Name | Dawit T Antonios |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1063461846 PECOS PAC ID: 6305807009 Enrollment ID: I20041026000398 |
| Provider Name | Rashmi A Kulkarni |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265651541 PECOS PAC ID: 8426011826 Enrollment ID: I20041108000020 |
| Provider Name | Leena Dutta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760429948 PECOS PAC ID: 6103880208 Enrollment ID: I20041118000219 |
| Provider Name | Adrian M Mogos |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1972610590 PECOS PAC ID: 7618932823 Enrollment ID: I20041130000534 |
| Provider Name | Adrine Sue Adams |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1649230970 PECOS PAC ID: 2769448539 Enrollment ID: I20041203000096 |
| Provider Name | Najeeb I Siddique |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1558313726 PECOS PAC ID: 2961307103 Enrollment ID: I20041215000975 |
| Provider Name | Anuradha Thopu |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1982698684 PECOS PAC ID: 4880644434 Enrollment ID: I20050201000003 |
| Provider Name | Murtaza Cassoobhoy |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1407936446 PECOS PAC ID: 1456306141 Enrollment ID: I20050315000998 |
| Provider Name | Patricia A Bird |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447285176 PECOS PAC ID: 3971558529 Enrollment ID: I20050316000384 |
| Provider Name | Peter E Anderson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1669426425 PECOS PAC ID: 8123073814 Enrollment ID: I20050607000511 |
| Provider Name | Christine D Lallos |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1013092733 PECOS PAC ID: 0648213850 Enrollment ID: I20050608000957 |
| Provider Name | David S Lee |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1225009228 PECOS PAC ID: 6002850252 Enrollment ID: I20050617000572 |
| Provider Name | Joseph E West |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1043375025 PECOS PAC ID: 5294770913 Enrollment ID: I20050623000165 |
| Provider Name | Olumuyiwa Adeoye Rotimi Joshua |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144322157 PECOS PAC ID: 5991748048 Enrollment ID: I20050708000705 |
| Provider Name | Tanna H Lim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720015084 PECOS PAC ID: 3476580861 Enrollment ID: I20050718000483 |
| Provider Name | Sudha P Reddy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1306871512 PECOS PAC ID: 3072542067 Enrollment ID: I20050810000464 |
| Provider Name | Michael Rinow |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619084654 PECOS PAC ID: 6002846664 Enrollment ID: I20050815000418 |
| Provider Name | Elizabeth L Atkins |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1487645677 PECOS PAC ID: 3577594043 Enrollment ID: I20050824000620 |
| Provider Name | Sean E Delaney |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1174557110 PECOS PAC ID: 2365473840 Enrollment ID: I20050824000664 |
| Provider Name | Khalid J Hayat |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1578563953 PECOS PAC ID: 6204869894 Enrollment ID: I20050914000672 |
| Provider Name | Darrell M Cheek |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932100724 PECOS PAC ID: 0749213007 Enrollment ID: I20050916000173 |
| Provider Name | Carmen C Mcgee |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851421606 PECOS PAC ID: 8426083080 Enrollment ID: I20051003000260 |
| Provider Name | Henry S Moon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780646083 PECOS PAC ID: 6709801194 Enrollment ID: I20051014000278 |
| Provider Name | Paul Skokanic |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548243959 PECOS PAC ID: 9032136775 Enrollment ID: I20051101000489 |
| Provider Name | Arati Joshi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437251246 PECOS PAC ID: 8022037894 Enrollment ID: I20051122000383 |
| Provider Name | Aldemar Montero |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1649229683 PECOS PAC ID: 2668483165 Enrollment ID: I20060517000008 |
| Provider Name | Satvir Singh |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1114969052 PECOS PAC ID: 6002828282 Enrollment ID: I20060707000327 |
| Provider Name | Paayal Madhukar Mehta |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1689613002 PECOS PAC ID: 7214940279 Enrollment ID: I20060718000036 |
| Provider Name | Earl Stephenson |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1487678751 PECOS PAC ID: 8820094311 Enrollment ID: I20061009000095 |
| Provider Name | Cynthia A Ham |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1871500991 PECOS PAC ID: 5991702532 Enrollment ID: I20061025000045 |
| Provider Name | Uy Q Vu |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1407876139 PECOS PAC ID: 9234137332 Enrollment ID: I20061128000511 |
| Provider Name | Olufunsho Bankole |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487714911 PECOS PAC ID: 2668474164 Enrollment ID: I20070213000513 |
| Provider Name | Susan E Eldred |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770679128 PECOS PAC ID: 4587767850 Enrollment ID: I20070307000567 |
| Provider Name | Neelima Dachuri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427136779 PECOS PAC ID: 0749383800 Enrollment ID: I20070309000183 |
| Provider Name | James M Dorchak |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609972868 PECOS PAC ID: 3779687660 Enrollment ID: I20070403000041 |
| Provider Name | Mohiuddin A Syed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649342791 PECOS PAC ID: 6002910627 Enrollment ID: I20070409000198 |
| Provider Name | Gedion A Getachew |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1871633701 PECOS PAC ID: 1052416930 Enrollment ID: I20070423000045 |
| Provider Name | Kelly M Sklare |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1609913896 PECOS PAC ID: 8325144280 Enrollment ID: I20070509000596 |
| Provider Name | Irandathy Rodrigo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922067875 PECOS PAC ID: 8022118116 Enrollment ID: I20070702000415 |
| Provider Name | Adeyosoye Temitope Dawodu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932132685 PECOS PAC ID: 0840224077 Enrollment ID: I20070716000360 |
| Provider Name | Rodica S Ellis |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164588844 PECOS PAC ID: 1557462801 Enrollment ID: I20070731000200 |
| Provider Name | Milton L Alvarez |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992783476 PECOS PAC ID: 3870557564 Enrollment ID: I20070910000274 |
| Provider Name | Kimberly Shea |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1164568168 PECOS PAC ID: 5698861847 Enrollment ID: I20071018000574 |
| Provider Name | Jeffrey Nicholas |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942382445 PECOS PAC ID: 0941396931 Enrollment ID: I20071023000096 |
| Provider Name | Daniel J Frilingos |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1659422087 PECOS PAC ID: 9830286590 Enrollment ID: I20071029000363 |
| Provider Name | Tonya H Guldenschuh |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1821136516 PECOS PAC ID: 7315034675 Enrollment ID: I20071102000260 |
| Provider Name | Sharon S Joyce-bailey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982742656 PECOS PAC ID: 7911094057 Enrollment ID: I20071106000381 |
| Provider Name | Alan D Winston |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1336256841 PECOS PAC ID: 5092804088 Enrollment ID: I20071128000426 |
| Provider Name | Janet L Whaley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134118383 PECOS PAC ID: 4183691892 Enrollment ID: I20080201000319 |
| Provider Name | Crystal A Ledwith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366622250 PECOS PAC ID: 3779666417 Enrollment ID: I20080219000105 |
| Provider Name | Amy Xiuxiang J Lin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1245390467 PECOS PAC ID: 9234213596 Enrollment ID: I20080326000363 |
| Provider Name | Barry Mitchell Renz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1598815698 PECOS PAC ID: 4789762774 Enrollment ID: I20080416000146 |
| Provider Name | Romeo Massoud |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194875237 PECOS PAC ID: 5496833485 Enrollment ID: I20080416000170 |
| Provider Name | Peter K Nam |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1154473957 PECOS PAC ID: 1759450364 Enrollment ID: I20080522000469 |
| Provider Name | Quinn Simien |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1649326059 PECOS PAC ID: 0547339087 Enrollment ID: I20080523000056 |
| Provider Name | Martin L Austin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1760533418 PECOS PAC ID: 7618046160 Enrollment ID: I20080523000261 |
| Provider Name | Herschel W Smith |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1952455990 PECOS PAC ID: 9931270030 Enrollment ID: I20080617000661 |
| Provider Name | Madhuri Namuduri |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1407021652 PECOS PAC ID: 3173694726 Enrollment ID: I20080625000428 |
| Provider Name | Indie F Jones |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1053511568 PECOS PAC ID: 1052483328 Enrollment ID: I20080701000398 |
| Provider Name | Sudeshna Nandi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487671319 PECOS PAC ID: 9335211499 Enrollment ID: I20080707000243 |
| Provider Name | Christopher B Paul |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1114199932 PECOS PAC ID: 8426120304 Enrollment ID: I20080709000654 |
| Provider Name | Patrick Michael Mcgann |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1215107842 PECOS PAC ID: 8426124793 Enrollment ID: I20080910000507 |
| Provider Name | Joe F Clements |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1538154208 PECOS PAC ID: 1153412069 Enrollment ID: I20080917000087 |
| Provider Name | Hira Kohli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831230143 PECOS PAC ID: 4385712371 Enrollment ID: I20081003000434 |
| Provider Name | Seraj El Oshar |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1790958320 PECOS PAC ID: 2769550698 Enrollment ID: I20081006000406 |
| Provider Name | Michael J Pickford |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1013915586 PECOS PAC ID: 9032277330 Enrollment ID: I20081015000025 |
| Provider Name | Vasundhara Cheekati |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1023272283 PECOS PAC ID: 0446319636 Enrollment ID: I20081103000320 |
| Provider Name | John Sutton Harvey |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1609853795 PECOS PAC ID: 5890858724 Enrollment ID: I20090120000331 |
| Provider Name | Marc-andre Jean-gilles |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1255573952 PECOS PAC ID: 3678627650 Enrollment ID: I20090811000503 |
| Provider Name | Brian A Bledsoe |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1710159710 PECOS PAC ID: 5890840631 Enrollment ID: I20090901000143 |
| Provider Name | Bruce Barry Williams |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922203371 PECOS PAC ID: 6608921093 Enrollment ID: I20090909000245 |
| Provider Name | Toral M Fadia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689874299 PECOS PAC ID: 9133152283 Enrollment ID: I20091019000125 |
| Provider Name | Yimei M Qian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487801163 PECOS PAC ID: 3173690625 Enrollment ID: I20100122000202 |
| Provider Name | Denise Krackenberger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316101082 PECOS PAC ID: 6406998772 Enrollment ID: I20100125000575 |
| Provider Name | Sahil Tah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1831362649 PECOS PAC ID: 8527102292 Enrollment ID: I20100218000380 |
| Provider Name | Priya Baronia |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1710122684 PECOS PAC ID: 7911041108 Enrollment ID: I20100226000040 |
| Provider Name | Gregory P Schlegel |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1518010313 PECOS PAC ID: 3779628433 Enrollment ID: I20100305000064 |
| Provider Name | Kelli N Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104070457 PECOS PAC ID: 2264567783 Enrollment ID: I20100322000815 |
| Provider Name | Amy R Trent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992028963 PECOS PAC ID: 7416085378 Enrollment ID: I20100513000574 |
| Provider Name | Michelle Aimee Arp |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1922058163 PECOS PAC ID: 8820127889 Enrollment ID: I20100601000201 |
| Provider Name | Sylvia S Hung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629192109 PECOS PAC ID: 3779613468 Enrollment ID: I20100607000255 |
| Provider Name | Shashi Poddar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710907746 PECOS PAC ID: 1355473679 Enrollment ID: I20100721000547 |
| Provider Name | Olayinka A Akinpelu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1710130505 PECOS PAC ID: 6103959473 Enrollment ID: I20100806000549 |
| Provider Name | Rekha J Desai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073615878 PECOS PAC ID: 1355475096 Enrollment ID: I20100817000109 |
| Provider Name | Kartikeya P. Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215039029 PECOS PAC ID: 3870627516 Enrollment ID: I20100817000138 |
| Provider Name | Jay R. Desai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164524955 PECOS PAC ID: 0446384796 Enrollment ID: I20100823000419 |
| Provider Name | William F Mcgann |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1699751925 PECOS PAC ID: 4880728625 Enrollment ID: I20100909000792 |
| Provider Name | Jim M. John |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1841404233 PECOS PAC ID: 0547386922 Enrollment ID: I20100922000932 |
| Provider Name | James Alan Wolfe |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1194780338 PECOS PAC ID: 3779476494 Enrollment ID: I20101011000579 |
| Provider Name | Erica B Jin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023264231 PECOS PAC ID: 3678766052 Enrollment ID: I20101018000915 |
| Provider Name | Kevin Howard Peacock |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1679686661 PECOS PAC ID: 2163474347 Enrollment ID: I20101021000526 |
| Provider Name | Kevin L Jensen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1497855779 PECOS PAC ID: 7012091234 Enrollment ID: I20101108001413 |
| Provider Name | Melanie E Watkins |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639357767 PECOS PAC ID: 4587859640 Enrollment ID: I20101115000762 |
| Provider Name | Bamidele Ayotunde Ajibola |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669644589 PECOS PAC ID: 4082809009 Enrollment ID: I20101116000257 |
| Provider Name | Janice H Pressley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1194787549 PECOS PAC ID: 8729274543 Enrollment ID: I20101118001310 |
| Provider Name | Thinh Le Nguyen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1790016541 PECOS PAC ID: 4284821174 Enrollment ID: I20101203000959 |
| Provider Name | Otto Schwarz Vignolo |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1891712626 PECOS PAC ID: 2668477860 Enrollment ID: I20101214000324 |
| Provider Name | Alexander Saker |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1073602751 PECOS PAC ID: 2961516935 Enrollment ID: I20110111000135 |
| Provider Name | Ravi P Sarma |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1578670600 PECOS PAC ID: 8628184140 Enrollment ID: I20110111000162 |
| Provider Name | Anthony Landis |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1821187436 PECOS PAC ID: 8820044860 Enrollment ID: I20110111000223 |
| Provider Name | Brady Jf Banares |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1134424948 PECOS PAC ID: 9436332772 Enrollment ID: I20110324000485 |
| Provider Name | Susan M Mucha |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1447415906 PECOS PAC ID: 4082898044 Enrollment ID: I20110415000369 |
| Provider Name | Naila D Avery |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1700036613 PECOS PAC ID: 9537346788 Enrollment ID: I20110616000768 |
| Provider Name | George E Dasoveanu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558310334 PECOS PAC ID: 3072791110 Enrollment ID: I20110621000126 |
| Provider Name | Bhavinkumar P Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518138429 PECOS PAC ID: 8628256260 Enrollment ID: I20110629000467 |
| Provider Name | Mauree H Whitaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619262946 PECOS PAC ID: 0547448896 Enrollment ID: I20110711000162 |
| Provider Name | Vivekananda Pattabiraman |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1467649830 PECOS PAC ID: 1658402482 Enrollment ID: I20110726000739 |
| Provider Name | Patricia Necole Huelsbeck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841588712 PECOS PAC ID: 5395913834 Enrollment ID: I20110727000574 |
| Provider Name | Dragos Vladescu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457513186 PECOS PAC ID: 1557530623 Enrollment ID: I20110805000341 |
| Provider Name | Mariangeli Hamilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801837083 PECOS PAC ID: 7719082734 Enrollment ID: I20110907001525 |
| Provider Name | Ae Seon Cha |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1477520799 PECOS PAC ID: 7517966542 Enrollment ID: I20110914000735 |
| Provider Name | Rekha Kesavan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497908560 PECOS PAC ID: 7113198540 Enrollment ID: I20110915000439 |
| Provider Name | Luttrell L Toussaint |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134370711 PECOS PAC ID: 6709057425 Enrollment ID: I20110928000736 |
| Provider Name | Chinwe N Aligwekwe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609037936 PECOS PAC ID: 8426220427 Enrollment ID: I20111018000180 |
| Provider Name | Babatunde Edun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154624427 PECOS PAC ID: 7517130107 Enrollment ID: I20111027000905 |
| Provider Name | Venkateshwer R Routhu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1982827671 PECOS PAC ID: 0749453199 Enrollment ID: I20111031000120 |
| Provider Name | Conjeevaram R Kesavan |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1912968801 PECOS PAC ID: 9830363530 Enrollment ID: I20111115000236 |
| Provider Name | Julie D Gunby |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1073882262 PECOS PAC ID: 4284891110 Enrollment ID: I20120206000273 |
| Provider Name | Mohan K. Krishnamachary |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588625099 PECOS PAC ID: 4183632938 Enrollment ID: I20120410000194 |
| Provider Name | Latoya Leigh Wise |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1831456284 PECOS PAC ID: 3577727031 Enrollment ID: I20120613000166 |
| Provider Name | Okera S Hanshaw |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1801093703 PECOS PAC ID: 0446415566 Enrollment ID: I20120622000230 |
| Provider Name | Christina Hendry |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1174751754 PECOS PAC ID: 6608032677 Enrollment ID: I20120718000730 |
| Provider Name | Madhuri Nooka |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245443092 PECOS PAC ID: 5092888719 Enrollment ID: I20120720000018 |
| Provider Name | Sarah M Charlton |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1649530437 PECOS PAC ID: 7517123284 Enrollment ID: I20120724000855 |
| Provider Name | Barbara Robinson Henley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912063728 PECOS PAC ID: 0042341661 Enrollment ID: I20120821001086 |
| Provider Name | Janine R Jones |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1396966909 PECOS PAC ID: 1153578083 Enrollment ID: I20120829000298 |
| Provider Name | Susmita Rajanala |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1477612661 PECOS PAC ID: 1951558790 Enrollment ID: I20120829000530 |
| Provider Name | Kelly Scoggins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902160112 PECOS PAC ID: 2567610017 Enrollment ID: I20120907000344 |
| Provider Name | Francis Ampadu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083812515 PECOS PAC ID: 1850577842 Enrollment ID: I20120919000188 |
| Provider Name | Darbye Suzanne Mcclanahan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1720118763 PECOS PAC ID: 9234173261 Enrollment ID: I20121009000613 |
| Provider Name | Junghoon Park |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1386873925 PECOS PAC ID: 8628227428 Enrollment ID: I20121011000854 |
| Provider Name | David Braatz |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1730438920 PECOS PAC ID: 3476702143 Enrollment ID: I20121012000753 |
| Provider Name | Berhanu Kededa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184994105 PECOS PAC ID: 5991957011 Enrollment ID: I20121218000085 |
| Provider Name | Jena D Pugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790793479 PECOS PAC ID: 5092969196 Enrollment ID: I20130124000404 |
| Provider Name | Glory M Jason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598037434 PECOS PAC ID: 4789838640 Enrollment ID: I20130131000449 |
| Provider Name | Madeline Sutton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811033327 PECOS PAC ID: 4183878960 Enrollment ID: I20130201000165 |
| Provider Name | Christina Ann Beals |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1881696615 PECOS PAC ID: 2163319294 Enrollment ID: I20130429000183 |
| Provider Name | Deborah Schulte Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598712713 PECOS PAC ID: 3678712353 Enrollment ID: I20130611000267 |
| Provider Name | Mark D Darrow |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881697506 PECOS PAC ID: 4688587603 Enrollment ID: I20130624000165 |
| Provider Name | David S Grenda |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1336344928 PECOS PAC ID: 9234379264 Enrollment ID: I20130724000581 |
| Provider Name | Crichton Anne Hollingsworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013359306 PECOS PAC ID: 7810139128 Enrollment ID: I20130816000329 |
| Provider Name | Emory V Do |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1285649103 PECOS PAC ID: 7214996339 Enrollment ID: I20130819000671 |
| Provider Name | Matthew Kimball |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1174609556 PECOS PAC ID: 5193976421 Enrollment ID: I20130826000555 |
| Provider Name | Gregory Evans |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1073788816 PECOS PAC ID: 6800039355 Enrollment ID: I20130830000519 |
| Provider Name | Shivan Harish Amin |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1275857542 PECOS PAC ID: 4486898533 Enrollment ID: I20130911000826 |
| Provider Name | Gregory Strauther |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1972503837 PECOS PAC ID: 8022044841 Enrollment ID: I20131017001703 |
| Provider Name | Kevin E Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336138809 PECOS PAC ID: 0143249110 Enrollment ID: I20140228000363 |
| Provider Name | Anna M. Tupko Maloy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316361835 PECOS PAC ID: 1850521097 Enrollment ID: I20140307001159 |
| Provider Name | Julie A Hannah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871596353 PECOS PAC ID: 5890683536 Enrollment ID: I20140324000976 |
| Provider Name | Victor J Crespo |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1124442074 PECOS PAC ID: 2163655150 Enrollment ID: I20140428001008 |
| Provider Name | Dare Adewumi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265605091 PECOS PAC ID: 9133347446 Enrollment ID: I20140828001401 |
| Provider Name | Laurence So |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245273812 PECOS PAC ID: 6800959149 Enrollment ID: I20140904002156 |
| Provider Name | Nathan Michael Polite |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1184898223 PECOS PAC ID: 9931347168 Enrollment ID: I20140919000674 |
| Provider Name | Ragav Kurl |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730475757 PECOS PAC ID: 1052531043 Enrollment ID: I20140924002548 |
| Provider Name | Hiren P Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548566094 PECOS PAC ID: 7618197989 Enrollment ID: I20141008002290 |
| Provider Name | Elizabeth Ann Ziegler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942619093 PECOS PAC ID: 6406078914 Enrollment ID: I20141118002349 |
| Provider Name | Tracy Leigh Rider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245621168 PECOS PAC ID: 6507183670 Enrollment ID: I20150330001460 |
| Provider Name | Finda L Guyton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1255322582 PECOS PAC ID: 1355245259 Enrollment ID: I20150421001441 |
| Provider Name | Praveen Sivakumaran |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1023226081 PECOS PAC ID: 1658427166 Enrollment ID: I20150521001869 |
| Provider Name | Paige Gantt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487048591 PECOS PAC ID: 1052631504 Enrollment ID: I20150522001622 |
| Provider Name | Matthew D Darrow |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1730445800 PECOS PAC ID: 5799097630 Enrollment ID: I20150706002237 |
| Provider Name | Nidhip Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831416270 PECOS PAC ID: 2466696190 Enrollment ID: I20150715002295 |
| Provider Name | Matthew Aaron Hazzard |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1184858292 PECOS PAC ID: 4486967296 Enrollment ID: I20150723007034 |
| Provider Name | Nastasia S Ardalan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205223179 PECOS PAC ID: 4082920723 Enrollment ID: I20150826001591 |
| Provider Name | Priyadarshi Shardul Kurl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528322450 PECOS PAC ID: 5496994329 Enrollment ID: I20150827003036 |
| Provider Name | Ashwani Kumar Joshi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609051630 PECOS PAC ID: 0042358715 Enrollment ID: I20150928001750 |
| Provider Name | Betsy S Mitcham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417387382 PECOS PAC ID: 0547575128 Enrollment ID: I20151104000361 |
| Provider Name | Obiajulu C Okafor |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558583658 PECOS PAC ID: 9739242983 Enrollment ID: I20151110003109 |
| Provider Name | Kathleen Holland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447652698 PECOS PAC ID: 5698075521 Enrollment ID: I20151130000114 |
| Provider Name | Michelle Aimee Arp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922058163 PECOS PAC ID: 8820127889 Enrollment ID: I20151203002354 |
| Provider Name | Kim Schultheiss |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1831227560 PECOS PAC ID: 4082792510 Enrollment ID: I20151208003253 |
| Provider Name | Stephanie Anne Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215308515 PECOS PAC ID: 4082915384 Enrollment ID: I20151210000584 |
| Provider Name | Crystal Dale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245612654 PECOS PAC ID: 9133420987 Enrollment ID: I20151221000625 |
| Provider Name | William James Epps |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1982765285 PECOS PAC ID: 1254642622 Enrollment ID: I20151230001590 |
| Provider Name | Dave Seecharan |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1174789416 PECOS PAC ID: 0042435406 Enrollment ID: I20160128001486 |
| Provider Name | Shannon Willis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487971263 PECOS PAC ID: 6709027436 Enrollment ID: I20160204002026 |
| Provider Name | Erine Olivia Raybon-rojas |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1265660310 PECOS PAC ID: 0648402347 Enrollment ID: I20160208000922 |
| Provider Name | Mildred Rivera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568486298 PECOS PAC ID: 8325029036 Enrollment ID: I20160426001369 |
| Provider Name | Marie Alberte Altidor |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1043452444 PECOS PAC ID: 4981754314 Enrollment ID: I20160616001133 |
| Provider Name | Jennifer L Finney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922467943 PECOS PAC ID: 9133410301 Enrollment ID: I20160617001005 |
| Provider Name | Amimi Osayande |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821288077 PECOS PAC ID: 0446327530 Enrollment ID: I20160627001688 |
| Provider Name | Amy B Mahaley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386099604 PECOS PAC ID: 9537450218 Enrollment ID: I20160628001342 |
| Provider Name | Zachary Paul Cohen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356630586 PECOS PAC ID: 5799093092 Enrollment ID: I20160707001476 |
| Provider Name | Krystal Knight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215386396 PECOS PAC ID: 6709179401 Enrollment ID: I20160718001768 |
| Provider Name | Angelica J Huff |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1770934978 PECOS PAC ID: 1658665021 Enrollment ID: I20160808001548 |
| Provider Name | Bethwel Raore |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1215114475 PECOS PAC ID: 8921263872 Enrollment ID: I20160810000628 |
| Provider Name | Deborah A Taylor |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073737680 PECOS PAC ID: 6608954524 Enrollment ID: I20160816000943 |
| Provider Name | Letitia Stewart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366812562 PECOS PAC ID: 4486964954 Enrollment ID: I20160916000538 |
| Provider Name | Connie Shrake |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1891193082 PECOS PAC ID: 1153618491 Enrollment ID: I20160929001865 |
| Provider Name | Adam D. Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801248489 PECOS PAC ID: 3678861036 Enrollment ID: I20161018001226 |
| Provider Name | Merrissa Gallegos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235689498 PECOS PAC ID: 7911285580 Enrollment ID: I20161102001009 |
| Provider Name | Kristopher K Mcjenkin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255779351 PECOS PAC ID: 7810299906 Enrollment ID: I20161108002237 |
| Provider Name | Ian K Mcleod |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1255322145 PECOS PAC ID: 2860670429 Enrollment ID: I20170224000534 |
| Provider Name | Fernando Abad |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1437160322 PECOS PAC ID: 8921132077 Enrollment ID: I20170316002323 |
| Provider Name | Ayodeji Olarewaju |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1467711960 PECOS PAC ID: 4789952805 Enrollment ID: I20170614001362 |
| Provider Name | Johana Medina Ortiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952765869 PECOS PAC ID: 3274801261 Enrollment ID: I20170703001989 |
| Provider Name | Gul R Mughal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548605447 PECOS PAC ID: 1052613106 Enrollment ID: I20170713001932 |
| Provider Name | Roger Vega Blanco |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376983114 PECOS PAC ID: 0648540294 Enrollment ID: I20170714001298 |
| Provider Name | Donovan E Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316173875 PECOS PAC ID: 6608171426 Enrollment ID: I20170719000447 |
| Provider Name | Bingyan Wang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306263819 PECOS PAC ID: 6204142375 Enrollment ID: I20170724000521 |
| Provider Name | Tiffany Quinton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275994261 PECOS PAC ID: 3274803200 Enrollment ID: I20170724002347 |
| Provider Name | Lisa G Holcomb Neuman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1386818425 PECOS PAC ID: 8921251968 Enrollment ID: I20170815001164 |
| Provider Name | Tik Pau |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114347580 PECOS PAC ID: 2668788514 Enrollment ID: I20170816001947 |
| Provider Name | Antwuan G Allen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1194263624 PECOS PAC ID: 9436422938 Enrollment ID: I20170905002962 |
| Provider Name | Archana Parthasarathi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508200130 PECOS PAC ID: 3173802154 Enrollment ID: I20171009003051 |
| Provider Name | Dorothy A Amaka |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1588902282 PECOS PAC ID: 0345488326 Enrollment ID: I20171009003154 |
| Provider Name | Jessica Esther Harroche |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1477834398 PECOS PAC ID: 2365720802 Enrollment ID: I20171013001056 |
| Provider Name | Sridhar Rajamani |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1073576005 PECOS PAC ID: 8628047453 Enrollment ID: I20171017003637 |
| Provider Name | Arham K Barakzai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841610417 PECOS PAC ID: 8527360536 Enrollment ID: I20171024000643 |
| Provider Name | Shadae L Mcmillan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285186452 PECOS PAC ID: 3678849007 Enrollment ID: I20171030001812 |
| Provider Name | Frederick Griffin Powell |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1649569591 PECOS PAC ID: 3476785395 Enrollment ID: I20171219001126 |
| Provider Name | Debra R Miller |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1447255864 PECOS PAC ID: 7315844214 Enrollment ID: I20180103000378 |
| Provider Name | Nomsa Musemwa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639437510 PECOS PAC ID: 2961762257 Enrollment ID: I20180206001114 |
| Provider Name | Rachael Springer |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1457589186 PECOS PAC ID: 9133436900 Enrollment ID: I20180219002429 |
| Provider Name | I-wen Chang |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1912034471 PECOS PAC ID: 5496847071 Enrollment ID: I20180525000793 |
| Provider Name | Jennifer Kang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205353422 PECOS PAC ID: 9830444017 Enrollment ID: I20180611002701 |
| Provider Name | Amjid Muhammad Nawaz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720379142 PECOS PAC ID: 1658518519 Enrollment ID: I20180614002451 |
| Provider Name | Marcia Elesea Mcintyre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518322841 PECOS PAC ID: 7719277128 Enrollment ID: I20180619002381 |
| Provider Name | Enyinnaya K. Uwaekwe |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1760938963 PECOS PAC ID: 4284921982 Enrollment ID: I20180711002669 |
| Provider Name | Bernard Matthew Kim |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1316081755 PECOS PAC ID: 5799949319 Enrollment ID: I20180717001048 |
| Provider Name | Jeanette Dormio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427561836 PECOS PAC ID: 9234486309 Enrollment ID: I20180719003485 |
| Provider Name | Kushal P Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1346500477 PECOS PAC ID: 9830400712 Enrollment ID: I20180721000138 |
| Provider Name | Gabrielle Dawkins |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558740050 PECOS PAC ID: 9133418296 Enrollment ID: I20180725004007 |
| Provider Name | Nhu-thao Anico |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427552165 PECOS PAC ID: 8628325313 Enrollment ID: I20180726002040 |
| Provider Name | Li-kun Tu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972507630 PECOS PAC ID: 3476515198 Enrollment ID: I20180731002019 |
| Provider Name | Catherine Ashby Martin Assink |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1679064729 PECOS PAC ID: 8820346380 Enrollment ID: I20180731003938 |
| Provider Name | Hawah Comfort Guar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194220608 PECOS PAC ID: 8628327145 Enrollment ID: I20180816002167 |
| Provider Name | Rabeeh Idris El-refadi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1780997791 PECOS PAC ID: 4385876960 Enrollment ID: I20180821002343 |
| Provider Name | James H Lin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215950944 PECOS PAC ID: 8628327780 Enrollment ID: I20180822002361 |
| Provider Name | Olufunso Odunukan |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1780815308 PECOS PAC ID: 9537332143 Enrollment ID: I20180904003014 |
| Provider Name | Muhammad Khan |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1841551165 PECOS PAC ID: 3779884739 Enrollment ID: I20180927001925 |
| Provider Name | Antonette Olympia Sanderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538654983 PECOS PAC ID: 3577816610 Enrollment ID: I20181019000392 |
| Provider Name | Sheila Y Srinivasan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1881664852 PECOS PAC ID: 8224072731 Enrollment ID: I20181027000190 |
| Provider Name | Keli W. Chapman |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1154810299 PECOS PAC ID: 4880947134 Enrollment ID: I20181102001150 |
| Provider Name | Lourens J Willekes |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1255422267 PECOS PAC ID: 0244293355 Enrollment ID: I20181114003314 |
| Provider Name | Ramandeep Kaur Bambrah |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1467687566 PECOS PAC ID: 4880819671 Enrollment ID: I20181203000967 |
| Provider Name | Padmavathi V. Pagadala |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174683544 PECOS PAC ID: 4880750488 Enrollment ID: I20181211003742 |
| Provider Name | Tamika Lynette Saunders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205324548 PECOS PAC ID: 0749525038 Enrollment ID: I20181213003235 |
| Provider Name | Amanda Marie Overton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144795949 PECOS PAC ID: 6103162557 Enrollment ID: I20190107002165 |
| Provider Name | Joshua Charles Appelstein |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1508029612 PECOS PAC ID: 8325356967 Enrollment ID: I20190116001406 |
| Provider Name | Heather Horton |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861754657 PECOS PAC ID: 0244476901 Enrollment ID: I20190129002126 |
| Provider Name | Folusho Stephen Tugbiyele |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912936758 PECOS PAC ID: 6800862863 Enrollment ID: I20190222001277 |
| Provider Name | Jannette Marva Porter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497229892 PECOS PAC ID: 3678812104 Enrollment ID: I20190228000808 |
| Provider Name | Viju Varghese |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700292208 PECOS PAC ID: 9032482146 Enrollment ID: I20190306003447 |
| Provider Name | Yelitza Mari Guzman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477116564 PECOS PAC ID: 0143563742 Enrollment ID: I20190522003380 |
| Provider Name | Arturo Gilberto Torres |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1871657221 PECOS PAC ID: 4587980057 Enrollment ID: I20190606000039 |
| Provider Name | Yetunde O Olutunmbi |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1639313364 PECOS PAC ID: 5496973174 Enrollment ID: I20190606002840 |
| Provider Name | Abraham Tekeher Getenet |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1760758569 PECOS PAC ID: 9931413614 Enrollment ID: I20190615000136 |
| Provider Name | Junaid Nasir |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1972850055 PECOS PAC ID: 2062630809 Enrollment ID: I20190701001625 |
| Provider Name | Amber Y Kuk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417377821 PECOS PAC ID: 8820396724 Enrollment ID: I20190805000911 |
| Provider Name | Smitha C Varughese |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1952503344 PECOS PAC ID: 0345390217 Enrollment ID: I20190817000427 |
| Provider Name | Samuel Shapiro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851754519 PECOS PAC ID: 6103111364 Enrollment ID: I20190906002400 |
| Provider Name | Jin Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235591678 PECOS PAC ID: 8022301167 Enrollment ID: I20190916003074 |
| Provider Name | Emeka E Ihenatu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841653508 PECOS PAC ID: 6002102407 Enrollment ID: I20190917000870 |
| Provider Name | Min Jung Kim |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1174861892 PECOS PAC ID: 9638463029 Enrollment ID: I20190925001296 |
| Provider Name | Danielle Mccarthur |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245617505 PECOS PAC ID: 5597097410 Enrollment ID: I20191025002384 |
| Provider Name | Kacie J Graves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871143396 PECOS PAC ID: 0547592339 Enrollment ID: I20191028002907 |
| Provider Name | Linda Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982050969 PECOS PAC ID: 6608163530 Enrollment ID: I20191029001891 |
| Provider Name | Sarah Park |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568884617 PECOS PAC ID: 9234438003 Enrollment ID: I20200224002696 |
| Provider Name | Tonya Marie Hemmings |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1154969491 PECOS PAC ID: 0547697963 Enrollment ID: I20200225001701 |
| Provider Name | Richard L Glover |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871857482 PECOS PAC ID: 6709024946 Enrollment ID: I20200310001696 |
| Provider Name | Matthew Byrnes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063545317 PECOS PAC ID: 9739280603 Enrollment ID: I20200401002465 |
| Provider Name | Samreen Bhimani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174983696 PECOS PAC ID: 4789013020 Enrollment ID: I20200407002817 |
| Provider Name | Irwin M Reich |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1578551073 PECOS PAC ID: 8325023039 Enrollment ID: I20200416002347 |
| Provider Name | Magdy N Falestiny |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942421581 PECOS PAC ID: 8527954122 Enrollment ID: I20200421000965 |
| Provider Name | Marcus Antonio Walton |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1295962603 PECOS PAC ID: 2668704040 Enrollment ID: I20200427002002 |
| Provider Name | Benjamin Hayes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619330875 PECOS PAC ID: 0941593081 Enrollment ID: I20200507000801 |
| Provider Name | Abdrahim N Aloud |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1699179556 PECOS PAC ID: 5991097602 Enrollment ID: I20200522001868 |
| Provider Name | Nam C Huynh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073041695 PECOS PAC ID: 4082967484 Enrollment ID: I20200619001771 |
| Provider Name | Adarsh Kumar Srivastava |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1346486446 PECOS PAC ID: 6204001456 Enrollment ID: I20200622000907 |
| Provider Name | Saema A Tahir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821355165 PECOS PAC ID: 1355583717 Enrollment ID: I20200729002906 |
| Provider Name | Avital Perry |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1750722484 PECOS PAC ID: 9638311996 Enrollment ID: I20200825003397 |
| Provider Name | Larry V Carson |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1588764385 PECOS PAC ID: 4183600893 Enrollment ID: I20200831001771 |
| Provider Name | Vandene Tamoy Miller-adams |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1033567219 PECOS PAC ID: 4587081583 Enrollment ID: I20200903003245 |
| Provider Name | Albert Duane Hancock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144838665 PECOS PAC ID: 1557789518 Enrollment ID: I20200908003372 |
| Provider Name | Evan Winograd |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1538426549 PECOS PAC ID: 3173861747 Enrollment ID: I20200911001600 |
| Provider Name | Gary Collins |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1245286905 PECOS PAC ID: 4789610338 Enrollment ID: I20200915001314 |
| Provider Name | Ali Seyed Nabavi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891131652 PECOS PAC ID: 0143526749 Enrollment ID: I20200915002905 |
| Provider Name | Jason D Kennedy |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1447391677 PECOS PAC ID: 2365488046 Enrollment ID: I20200924000335 |
| Provider Name | Christopher M Mallow |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1326333279 PECOS PAC ID: 0042449613 Enrollment ID: I20200924000460 |
| Provider Name | Young-gwang Jeong |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1194122689 PECOS PAC ID: 3971837089 Enrollment ID: I20200924000638 |
| Provider Name | Jolomi N Iyoha |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679992002 PECOS PAC ID: 4183926462 Enrollment ID: I20201008000935 |
| Provider Name | Jolly Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376914184 PECOS PAC ID: 4082909635 Enrollment ID: I20201022002189 |
| Provider Name | Oluwaseun Davies |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1164779179 PECOS PAC ID: 6002127990 Enrollment ID: I20201119002554 |
| Provider Name | Alejandro J Luis |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1700087251 PECOS PAC ID: 4385893338 Enrollment ID: I20201125000139 |
| Provider Name | Xing Gao |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1659490944 PECOS PAC ID: 2163694811 Enrollment ID: I20201203000739 |
| Provider Name | John Sharp |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295113975 PECOS PAC ID: 1557662442 Enrollment ID: I20201222000828 |
| Provider Name | Elizabeth J Noyes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275649105 PECOS PAC ID: 4789907759 Enrollment ID: I20201230001740 |
| Provider Name | Yan Lin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023436474 PECOS PAC ID: 9234416801 Enrollment ID: I20201230002558 |
| Provider Name | Mariam Aderoju Dosunmu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912460429 PECOS PAC ID: 6901132083 Enrollment ID: I20210122002280 |
| Provider Name | Priscilla Agbenyefia |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1851786420 PECOS PAC ID: 6305159179 Enrollment ID: I20210217000369 |
| Provider Name | Ashish Ramesh Thakkar |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1538456124 PECOS PAC ID: 3274758263 Enrollment ID: I20210217000955 |
| Provider Name | Eric Macdonald York |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891384343 PECOS PAC ID: 0446665640 Enrollment ID: I20210222001659 |
| Provider Name | Alexander Evans |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1407939754 PECOS PAC ID: 3274597919 Enrollment ID: I20210330001317 |
| Provider Name | Elijah Kim |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1003045097 PECOS PAC ID: 0840500906 Enrollment ID: I20210427002705 |
| Provider Name | Katy M Deljoui Young |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700012143 PECOS PAC ID: 0446497911 Enrollment ID: I20210504002744 |
| Provider Name | Erwin Douyon |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649420464 PECOS PAC ID: 0749313609 Enrollment ID: I20210513001060 |
| Provider Name | Hatem Al Kassem |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609211481 PECOS PAC ID: 4688978158 Enrollment ID: I20210514000406 |
| Provider Name | Robert Todd Sautter |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1497172423 PECOS PAC ID: 1759654858 Enrollment ID: I20210520002940 |
| Provider Name | Melissa Ann Powell |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1053407809 PECOS PAC ID: 6002713450 Enrollment ID: I20210525000803 |
| Provider Name | Jamila-duyen Pham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932604899 PECOS PAC ID: 0941552780 Enrollment ID: I20210602000001 |
| Provider Name | Joshuam A Ruiz Vega |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639673247 PECOS PAC ID: 4284983545 Enrollment ID: I20210604001026 |
| Provider Name | Rehman Bienvenido Ahmad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174027080 PECOS PAC ID: 7315291580 Enrollment ID: I20210709000460 |
| Provider Name | Pranav Mehul Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1811484165 PECOS PAC ID: 2062769144 Enrollment ID: I20210721002663 |
| Provider Name | Jordan Douglas Duhon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750888046 PECOS PAC ID: 4880947308 Enrollment ID: I20210730001673 |
| Provider Name | Zhuocheng Su |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578057303 PECOS PAC ID: 7315283603 Enrollment ID: I20210813001269 |
| Provider Name | Neegum Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659875490 PECOS PAC ID: 2062765589 Enrollment ID: I20210903000710 |
| Provider Name | Mark David Williams |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1447663679 PECOS PAC ID: 3779877709 Enrollment ID: I20210913002047 |
| Provider Name | David Carter |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1578943833 PECOS PAC ID: 6800196072 Enrollment ID: I20210921000537 |
| Provider Name | Justin P Alexander |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1831552454 PECOS PAC ID: 5496091241 Enrollment ID: I20210924001473 |
| Provider Name | Lamar Marquis Ward |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437568706 PECOS PAC ID: 7012214455 Enrollment ID: I20210928000977 |
| Provider Name | Jiawen Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730673328 PECOS PAC ID: 3779829023 Enrollment ID: I20210928001064 |
| Provider Name | Heidi Lynn Sun Davis |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1952490229 PECOS PAC ID: 4284636119 Enrollment ID: I20211028003091 |
| Provider Name | Abiodun Laoye |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255754198 PECOS PAC ID: 9335459601 Enrollment ID: I20211105002419 |
| Provider Name | Katie Elizabeth Tuggle |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1972038800 PECOS PAC ID: 2769753953 Enrollment ID: I20211109003472 |
| Provider Name | Ji Hye Kwon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285000570 PECOS PAC ID: 5294029955 Enrollment ID: I20211117003159 |
| Provider Name | Shayan Khorsandzadeh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912430562 PECOS PAC ID: 7810319134 Enrollment ID: I20211123000133 |
| Provider Name | Rishim Ketan Jayswal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629565353 PECOS PAC ID: 7719216530 Enrollment ID: I20211213002719 |
| Provider Name | Celestin Akelyn Ekokobe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467049577 PECOS PAC ID: 6608268818 Enrollment ID: I20220120002517 |
| Provider Name | Stephanie Marie Baker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083148324 PECOS PAC ID: 7810266996 Enrollment ID: I20220128000434 |
| Provider Name | Janet Marlene Denton-bennett |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1356778112 PECOS PAC ID: 6103014782 Enrollment ID: I20220216000695 |
| Provider Name | Jason Lewis Fordyce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346816865 PECOS PAC ID: 5890189260 Enrollment ID: I20220301000426 |
| Provider Name | Gina Harris |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1104272194 PECOS PAC ID: 1759675960 Enrollment ID: I20220329000467 |
| Provider Name | Jean Lee Varner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598350175 PECOS PAC ID: 6800283953 Enrollment ID: I20220420001819 |
| Provider Name | Brittany Mary Nicole Sproul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689324345 PECOS PAC ID: 4486035623 Enrollment ID: I20220719001306 |
| Provider Name | Eloho Obatare Nanna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962147744 PECOS PAC ID: 2567844194 Enrollment ID: I20220729000314 |
| Provider Name | Brandon Jamal Hamm |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710447206 PECOS PAC ID: 5193059731 Enrollment ID: I20220808003370 |
| Provider Name | Nouman Tanveer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740847847 PECOS PAC ID: 3779817416 Enrollment ID: I20220831000186 |
| Provider Name | Shakese Melina Hudley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417337759 PECOS PAC ID: 9830426030 Enrollment ID: I20230125002291 |
| Provider Name | Claudia Hildegard Southern |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831588383 PECOS PAC ID: 2466712344 Enrollment ID: I20230126001033 |
| Provider Name | Mohamed Mothman Mahfoud |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1194135939 PECOS PAC ID: 3870864705 Enrollment ID: I20230503001353 |
| Provider Name | Fauziya A Ali |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699291039 PECOS PAC ID: 8921463449 Enrollment ID: I20230504002628 |
| Provider Name | Lakshmipathi Gupta Nomula |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992090864 PECOS PAC ID: 8224207733 Enrollment ID: I20230515001859 |
| Provider Name | Lauren Kae Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013627900 PECOS PAC ID: 7012374374 Enrollment ID: I20230601002404 |
| Provider Name | Amy M Fox |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1578529186 PECOS PAC ID: 5799779542 Enrollment ID: I20230628003228 |
| Provider Name | Cecille A Tapia-santiago |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1386693877 PECOS PAC ID: 0244229508 Enrollment ID: I20230717000800 |
| Provider Name | Ricardo A Dunmoodie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851929848 PECOS PAC ID: 6305262361 Enrollment ID: I20230717002164 |
| Provider Name | Mengistu Berie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992064935 PECOS PAC ID: 2062728363 Enrollment ID: I20230721003312 |
| Provider Name | Aaron Yaoyuan Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588292221 PECOS PAC ID: 4284057100 Enrollment ID: I20230801002293 |
| Provider Name | Azad Karim |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1720440282 PECOS PAC ID: 9739425810 Enrollment ID: I20230822004119 |
| Provider Name | Charles Freeman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679130611 PECOS PAC ID: 2961731880 Enrollment ID: I20230824003183 |
| Provider Name | Denise Gococo-benore |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1043779143 PECOS PAC ID: 1658605266 Enrollment ID: I20230825002656 |
| Provider Name | Teena Ann Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700329117 PECOS PAC ID: 3678850344 Enrollment ID: I20230829002283 |
| Provider Name | Justin Paul Cruz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093342990 PECOS PAC ID: 4284058454 Enrollment ID: I20230913000064 |
| Provider Name | Adrianna Kordek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730716101 PECOS PAC ID: 9032532502 Enrollment ID: I20231005000924 |
| Provider Name | Nicolas T Pham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083226708 PECOS PAC ID: 8527486893 Enrollment ID: I20231220000302 |
| Provider Name | Debbie-ann Kimberlin Daley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922870492 PECOS PAC ID: 7416307152 Enrollment ID: I20231221001453 |
| Provider Name | Terrence Carter |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144584764 PECOS PAC ID: 6709024938 Enrollment ID: I20231222002138 |
| Provider Name | Daneille Renae Mooney |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1881304111 PECOS PAC ID: 7810331717 Enrollment ID: I20240220000204 |
| Provider Name | Chauncey Ruthienee Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982758314 PECOS PAC ID: 5890717052 Enrollment ID: I20240306000129 |
| Provider Name | Ia Y Kue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902883143 PECOS PAC ID: 7416969852 Enrollment ID: I20240322002892 |
Clinica Familiar Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 706 Grayson Hwy, Suite 216, Lawrenceville, GA 30045 Phone: 770-513-7711 Fax: 770-513-3352 | |
Raymond L. Stovall, M.d., P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 600 Professional Dr, Suite 150, Lawrenceville, GA 30045 Phone: 678-376-1800 Fax: 678-376-5500 | |
Physicians Pointe Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1925 Old Peachtree Rd Ne, Lawrenceville, GA 30043 Phone: 770-339-5999 Fax: 770-277-9159 | |
Carehere Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 750 S Perry St Ste 200, Lawrenceville, GA 30046 Phone: 877-423-1330 | |
Bennett H. Bruckner,m.d., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 575 Professional Dr, Suite 290, Lawrenceville, GA 30045 Phone: 770-962-9410 Fax: 770-962-8489 | |
Metabolic Health Of Lawrenceville Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 720 Old Snellville Hwy Ste 150, Lawrenceville, GA 30044 Phone: 678-431-1119 | |
Sugarloaf Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4835 Sugarloaf Pkwy, Suite 300, Lawrenceville, GA 30044 Phone: 407-375-5940 Fax: 407-375-5952 |