Marcellus Medical Group Pllc | |
1/2 Orange St Marcellus NY 13108-1216 | |
(317) 673-1529 | |
(315) 673-2434 |
Full Name | Marcellus Medical Group Pllc |
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Speciality | Internal Medicine |
Location | 1/2 Orange St, Marcellus, New York |
Authorized Official Name and Position | Khatuna N Stepkovitch (PHYSICIAN/OWNER) |
Authorized Official Contact | 3156731529 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Marcellus Medical Group Pllc 1/2 Orange St Marcellus NY 13108-1216 Ph: (317) 673-1529 | Marcellus Medical Group Pllc 1/2 Orange St Marcellus NY 13108-1216 Ph: (317) 673-1529 |
NPI Number | 1437780335 |
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Provider Enumeration Date | 01/29/2020 |
Last Update Date | 08/04/2020 |
Medicare PECOS PAC ID | 9537584933 |
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Medicare Enrollment ID | O20200803000050 |
Identifier | Type | State | Issuer |
---|---|---|---|
1437780335 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Khatuna N Stepkovitch |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1568495323 PECOS PAC ID: 3173557139 Enrollment ID: I20050920000918 |
Marcellus Family Medicine Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 28 1/2 E Main St, Marcellus, NY 13108 Phone: 315-673-9926 |