| Marquette General Family Medicine - Marquette | |
|
1414 W Fair Ave Ste 36 Marquette MI 49855-2675 | |
| (906) 225-3864 | |
| (906) 225-3851 |
| Full Name | Marquette General Family Medicine - Marquette |
|---|---|
| Speciality | Internal Medicine |
| Location | 1414 W Fair Ave, Marquette, Michigan |
| Authorized Official Name and Position | Monica Bowman (PRESIDENT) |
| Authorized Official Contact | 6159207000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marquette General Family Medicine - Marquette 1414 W Fair Ave Ste 36 Marquette MI 49855-2675 Ph: (906) 225-3864 | Marquette General Family Medicine - Marquette 1414 W Fair Ave Ste 36 Marquette MI 49855-2675 Ph: (906) 225-3864 |
| NPI Number | 1487902995 |
|---|---|
| Provider Enumeration Date | 08/15/2012 |
| Last Update Date | 05/11/2023 |
| Medicare PECOS PAC ID | 9931359601 |
|---|---|
| Medicare Enrollment ID | O20121016000312 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487902995 | NPI | - | NPPES |
| Provider Name | Scott Michael Hagle |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497738090 PECOS PAC ID: 5294648846 Enrollment ID: I20031110000399 |
| Provider Name | Eduard Kotlyarov |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851348247 PECOS PAC ID: 7911811187 Enrollment ID: I20031113000268 |
| Provider Name | Richard E Vermeulen |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1285737379 PECOS PAC ID: 2961308226 Enrollment ID: I20031217000366 |
| Provider Name | Curtis Charles Marder |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1407892995 PECOS PAC ID: 1850290388 Enrollment ID: I20040105000336 |
| Provider Name | Jacqueline Kraus |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1417994401 PECOS PAC ID: 0345149381 Enrollment ID: I20040108000161 |
| Provider Name | David M Mccance |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275639361 PECOS PAC ID: 2860387800 Enrollment ID: I20040303000704 |
| Provider Name | Craig Thomas Coccia |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1194705947 PECOS PAC ID: 8820081912 Enrollment ID: I20040405001604 |
| Provider Name | William K Clegg |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1841241288 PECOS PAC ID: 1759271349 Enrollment ID: I20040420001156 |
| Provider Name | Rodney J Riesland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013998574 PECOS PAC ID: 7719974138 Enrollment ID: I20040428000507 |
| Provider Name | Dennis C Whitehead |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1659358547 PECOS PAC ID: 7113914052 Enrollment ID: I20040430000516 |
| Provider Name | Joel L Appel |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1811935273 PECOS PAC ID: 8729076542 Enrollment ID: I20040503000153 |
| Provider Name | Nathaniel R Woodruff |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1275623191 PECOS PAC ID: 0547250169 Enrollment ID: I20040515000362 |
| Provider Name | Martha A Frankowski |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003887290 PECOS PAC ID: 9133110885 Enrollment ID: I20040520001256 |
| Provider Name | Gary M Friesen |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1730123183 PECOS PAC ID: 4082691829 Enrollment ID: I20040630000675 |
| Provider Name | Omar Al-subee |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1194903708 PECOS PAC ID: 0143209478 Enrollment ID: I20040719001192 |
| Provider Name | Derek Mccalmont |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144394651 PECOS PAC ID: 7012989866 Enrollment ID: I20040811000814 |
| Provider Name | Jeffrey M Shipkey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1659354256 PECOS PAC ID: 4385611276 Enrollment ID: I20040910000987 |
| Provider Name | Christian M Dinsmore |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346232220 PECOS PAC ID: 7911966270 Enrollment ID: I20041004000776 |
| Provider Name | Michelle Sugiyama Caird |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1639279474 PECOS PAC ID: 9436118940 Enrollment ID: I20041008000621 |
| Provider Name | Aaron P Scholnik |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1487648028 PECOS PAC ID: 0345203204 Enrollment ID: I20041111000053 |
| Provider Name | Clevius A Curry |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1487989927 PECOS PAC ID: 2860450004 Enrollment ID: I20041221000012 |
| Provider Name | Elizabeth A Mackey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912923814 PECOS PAC ID: 5294793360 Enrollment ID: I20041221000962 |
| Provider Name | Swati Dutta |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1225054679 PECOS PAC ID: 7315936135 Enrollment ID: I20050106000455 |
| Provider Name | Ann L Silverman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1902974439 PECOS PAC ID: 8921056797 Enrollment ID: I20050107000701 |
| Provider Name | Amanda L Beerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689754251 PECOS PAC ID: 6901856442 Enrollment ID: I20050124000277 |
| Provider Name | Steven T Deroos |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528033990 PECOS PAC ID: 2769436393 Enrollment ID: I20050308000171 |
| Provider Name | Jurgen G Runschke |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1134166473 PECOS PAC ID: 0840246039 Enrollment ID: I20050330001167 |
| Provider Name | Osama H Alaradi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1265500789 PECOS PAC ID: 8820037666 Enrollment ID: I20050429000918 |
| Provider Name | Claude Douglas Lees |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1770572349 PECOS PAC ID: 1850330473 Enrollment ID: I20050503000278 |
| Provider Name | Linda Marie Opsahl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689603839 PECOS PAC ID: 1658311295 Enrollment ID: I20050503001183 |
| Provider Name | Michael Alan Wood |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1801866363 PECOS PAC ID: 0941243349 Enrollment ID: I20050607000448 |
| Provider Name | Roger Curtis Gietzen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508808072 PECOS PAC ID: 0042254120 Enrollment ID: I20050620000582 |
| Provider Name | Kenneth S Buran |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1033129390 PECOS PAC ID: 6709772098 Enrollment ID: I20050719000502 |
| Provider Name | Michael Heung |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1386726289 PECOS PAC ID: 3577594845 Enrollment ID: I20050826000030 |
| Provider Name | Jeffrey E Zapawa |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912943051 PECOS PAC ID: 5092740076 Enrollment ID: I20050928000772 |
| Provider Name | Catherine A Kroll |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043260995 PECOS PAC ID: 3274558580 Enrollment ID: I20051006000212 |
| Provider Name | Amy L Fletemier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942281977 PECOS PAC ID: 4587569728 Enrollment ID: I20051020000584 |
| Provider Name | Sheetal Sumat Acharya |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1932128097 PECOS PAC ID: 8729005152 Enrollment ID: I20051025001019 |
| Provider Name | William Michael Short |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720079569 PECOS PAC ID: 1153349394 Enrollment ID: I20051107000625 |
| Provider Name | Barbara Sue Mcgrath |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1780649327 PECOS PAC ID: 1557380938 Enrollment ID: I20051115000444 |
| Provider Name | Patricia A Newhouse |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972544401 PECOS PAC ID: 5395766109 Enrollment ID: I20051208000357 |
| Provider Name | Karen M Speirs |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1265520522 PECOS PAC ID: 7719900794 Enrollment ID: I20060104000928 |
| Provider Name | James R Addison |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1275517740 PECOS PAC ID: 3577586379 Enrollment ID: I20060106000760 |
| Provider Name | Richard L Tomacari |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437132065 PECOS PAC ID: 5698728285 Enrollment ID: I20060106000778 |
| Provider Name | Anthony A Holden |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1720086606 PECOS PAC ID: 4183605439 Enrollment ID: I20060131000152 |
| Provider Name | Brian David Jaffe |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1063407799 PECOS PAC ID: 7416962659 Enrollment ID: I20060209000371 |
| Provider Name | Kimberly Lohr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568576346 PECOS PAC ID: 8729098843 Enrollment ID: I20060503000324 |
| Provider Name | Ronald G Grifka |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386624666 PECOS PAC ID: 8921019373 Enrollment ID: I20060522000109 |
| Provider Name | Veslav Stecevic |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1659361806 PECOS PAC ID: 4587676424 Enrollment ID: I20060615000105 |
| Provider Name | Jeffrey M Wilseck |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1962449033 PECOS PAC ID: 2860397858 Enrollment ID: I20060626000283 |
| Provider Name | Anca E Andrei |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1538135645 PECOS PAC ID: 0244243178 Enrollment ID: I20060719000287 |
| Provider Name | Kristi R Olson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265480297 PECOS PAC ID: 7113987231 Enrollment ID: I20060727000023 |
| Provider Name | Steven J Verbridge |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093764706 PECOS PAC ID: 9830102185 Enrollment ID: I20060803000210 |
| Provider Name | Cormac Oliver Loughrey Maher |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1043229073 PECOS PAC ID: 5092751545 Enrollment ID: I20060915000549 |
| Provider Name | Bela Joanne Selzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811905946 PECOS PAC ID: 8325044019 Enrollment ID: I20061020000357 |
| Provider Name | Weiping Wang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164481842 PECOS PAC ID: 2769377225 Enrollment ID: I20061221000173 |
| Provider Name | Andrew G Boudreau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053330738 PECOS PAC ID: 4385646868 Enrollment ID: I20070213000315 |
| Provider Name | William D Parkkonen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851454276 PECOS PAC ID: 4486756582 Enrollment ID: I20070220000590 |
| Provider Name | Thomas D Legalley |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1255375614 PECOS PAC ID: 8224937735 Enrollment ID: I20070326000361 |
| Provider Name | Nelson E Gencheff |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1073557435 PECOS PAC ID: 6608970983 Enrollment ID: I20070326000385 |
| Provider Name | Mark D Cowan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1932144938 PECOS PAC ID: 2961506241 Enrollment ID: I20070326000397 |
| Provider Name | John M Pap |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093750085 PECOS PAC ID: 9931203213 Enrollment ID: I20070326000424 |
| Provider Name | Rhonda R Lampen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760412621 PECOS PAC ID: 2163477308 Enrollment ID: I20070330000245 |
| Provider Name | David A Pesola |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1285662015 PECOS PAC ID: 2860596632 Enrollment ID: I20070404000121 |
| Provider Name | Sandra Kay Mccowen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659467744 PECOS PAC ID: 1254307218 Enrollment ID: I20070413000340 |
| Provider Name | William J Jean |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1710922711 PECOS PAC ID: 9739091000 Enrollment ID: I20070417000422 |
| Provider Name | Cameron Daniel Wilcox |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386867711 PECOS PAC ID: 8123125713 Enrollment ID: I20070516000030 |
| Provider Name | Amy M Weise |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1245448042 PECOS PAC ID: 9032218425 Enrollment ID: I20070626000469 |
| Provider Name | Steven M Dowdy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457579898 PECOS PAC ID: 4587764063 Enrollment ID: I20070712000632 |
| Provider Name | Andrew Christian Stevens |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1508078098 PECOS PAC ID: 1850482852 Enrollment ID: I20070806000482 |
| Provider Name | Mary Lee Tobin-anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457578049 PECOS PAC ID: 6800987215 Enrollment ID: I20070814000186 |
| Provider Name | David C Grant |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1639261035 PECOS PAC ID: 2163323908 Enrollment ID: I20070910000212 |
| Provider Name | Nicole E Alexander |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1740359744 PECOS PAC ID: 3971578527 Enrollment ID: I20070926000978 |
| Provider Name | Ahmad L Subhi |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1245437953 PECOS PAC ID: 8426144429 Enrollment ID: I20071023000139 |
| Provider Name | Christianne Lenett Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275560138 PECOS PAC ID: 0648353920 Enrollment ID: I20080208000508 |
| Provider Name | Daniel D Hardie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669476925 PECOS PAC ID: 0042393316 Enrollment ID: I20080215000713 |
| Provider Name | Bryan E. Mcdonnell |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1780682781 PECOS PAC ID: 8022112937 Enrollment ID: I20080222000548 |
| Provider Name | James H Mering |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1881672335 PECOS PAC ID: 6608951678 Enrollment ID: I20080314000463 |
| Provider Name | Brian Gregory Waite |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205880085 PECOS PAC ID: 5092812982 Enrollment ID: I20080324000202 |
| Provider Name | Daniel M Buerkel |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1417075987 PECOS PAC ID: 1153407234 Enrollment ID: I20080331000079 |
| Provider Name | John E Dahlin |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1427194828 PECOS PAC ID: 7517053010 Enrollment ID: I20080425000055 |
| Provider Name | James P Picotte |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083786511 PECOS PAC ID: 9335212653 Enrollment ID: I20080721000285 |
| Provider Name | Richard W Frieden |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1336183045 PECOS PAC ID: 5799729240 Enrollment ID: I20080724000705 |
| Provider Name | Jennifer M Dehlin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669699245 PECOS PAC ID: 3678646411 Enrollment ID: I20080726000109 |
| Provider Name | Christon I Dums |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437376019 PECOS PAC ID: 1456425776 Enrollment ID: I20080805000629 |
| Provider Name | Safaa El Naggar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205828530 PECOS PAC ID: 1254406861 Enrollment ID: I20080815000690 |
| Provider Name | Paul Alan Lahaye |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1134178239 PECOS PAC ID: 0345315610 Enrollment ID: I20080821000611 |
| Provider Name | Joel Ryan Dank |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073730669 PECOS PAC ID: 4486720950 Enrollment ID: I20080906000201 |
| Provider Name | Carole Spickerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225293673 PECOS PAC ID: 7214004241 Enrollment ID: I20080917000382 |
| Provider Name | Bradford K Grassmick |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1356333181 PECOS PAC ID: 6103984174 Enrollment ID: I20081020000370 |
| Provider Name | James B Dixon |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1316164890 PECOS PAC ID: 6709944663 Enrollment ID: I20081021000564 |
| Provider Name | Frederick Peter Jaecklein |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306828009 PECOS PAC ID: 8022179423 Enrollment ID: I20081203000833 |
| Provider Name | Cynthia L Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760602478 PECOS PAC ID: 1951464890 Enrollment ID: I20090120000456 |
| Provider Name | Paul R Kemmeter |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548217946 PECOS PAC ID: 8628132255 Enrollment ID: I20090128000371 |
| Provider Name | Erica J Griffin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477536761 PECOS PAC ID: 7214092949 Enrollment ID: I20090212000654 |
| Provider Name | Asif Azeem |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1932288248 PECOS PAC ID: 6204856941 Enrollment ID: I20090416000694 |
| Provider Name | Tonia D Kroll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225238991 PECOS PAC ID: 3779645858 Enrollment ID: I20090423000468 |
| Provider Name | Virginia V Harrington |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1487635850 PECOS PAC ID: 6406754381 Enrollment ID: I20090428000456 |
| Provider Name | Amanda Jean Schafer Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396987871 PECOS PAC ID: 9739238874 Enrollment ID: I20090521000058 |
| Provider Name | Lara Clary-lantis |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1093894164 PECOS PAC ID: 6507828837 Enrollment ID: I20090528000117 |
| Provider Name | Wihib A Gebregeorgis |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366632713 PECOS PAC ID: 8729139522 Enrollment ID: I20090707000371 |
| Provider Name | John L Lehtinen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346242732 PECOS PAC ID: 4385796903 Enrollment ID: I20090713000438 |
| Provider Name | Carrie Marie Hayen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881800530 PECOS PAC ID: 2769534841 Enrollment ID: I20090721000429 |
| Provider Name | Santosh Gowda |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1639259823 PECOS PAC ID: 8921151200 Enrollment ID: I20090804000425 |
| Provider Name | Dana M Ransom |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649408634 PECOS PAC ID: 0941355929 Enrollment ID: I20090826000706 |
| Provider Name | Kevin S Gostenik |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477743383 PECOS PAC ID: 6103971742 Enrollment ID: I20090902000511 |
| Provider Name | Lisa M Long |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326039462 PECOS PAC ID: 4082760939 Enrollment ID: I20090918000309 |
| Provider Name | Kelley A Mahar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568494722 PECOS PAC ID: 7911043989 Enrollment ID: I20091005000529 |
| Provider Name | Frederick P Hoenke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710978853 PECOS PAC ID: 0547307522 Enrollment ID: I20091023000197 |
| Provider Name | Derek T Nagle |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942413844 PECOS PAC ID: 9335286103 Enrollment ID: I20091027000752 |
| Provider Name | Brian J Macfalda |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1013130053 PECOS PAC ID: 8628116662 Enrollment ID: I20091111000260 |
| Provider Name | Cynthia L Jensen |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1871553255 PECOS PAC ID: 6901835461 Enrollment ID: I20091111000528 |
| Provider Name | Inas Hanna Thomas |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1871627125 PECOS PAC ID: 3971642505 Enrollment ID: I20091120000199 |
| Provider Name | Katherine H Houle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689669848 PECOS PAC ID: 9234270885 Enrollment ID: I20100105000536 |
| Provider Name | David L Gaston |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1811000227 PECOS PAC ID: 0749322576 Enrollment ID: I20100116000251 |
| Provider Name | Carl F Eiben |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1053308395 PECOS PAC ID: 0749218659 Enrollment ID: I20100128000756 |
| Provider Name | Marybeth Hines |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497704480 PECOS PAC ID: 8820174998 Enrollment ID: I20100130000092 |
| Provider Name | Ram K Menon |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649284860 PECOS PAC ID: 8921990524 Enrollment ID: I20100306000109 |
| Provider Name | Suzanne M Clarke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932190832 PECOS PAC ID: 5698800845 Enrollment ID: I20100312001024 |
| Provider Name | David C Shahbazi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558352393 PECOS PAC ID: 9537294491 Enrollment ID: I20100317000255 |
| Provider Name | Jerold Steven Napier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376526707 PECOS PAC ID: 6800921735 Enrollment ID: I20100317000952 |
| Provider Name | Francis P Darr |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548293756 PECOS PAC ID: 7214062066 Enrollment ID: I20100318000088 |
| Provider Name | Clark Edward Nugent |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1902993769 PECOS PAC ID: 0547395204 Enrollment ID: I20100319000220 |
| Provider Name | John R Wallace |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1457346967 PECOS PAC ID: 8527193036 Enrollment ID: I20100322000729 |
| Provider Name | Mark C Chames |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750474961 PECOS PAC ID: 4880636273 Enrollment ID: I20100325001040 |
| Provider Name | Stuart K Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861483901 PECOS PAC ID: 6204962483 Enrollment ID: I20100326000465 |
| Provider Name | Hendrik C Vandenende |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750372892 PECOS PAC ID: 6608902176 Enrollment ID: I20100414000174 |
| Provider Name | Ellen L Kehoe |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1619975513 PECOS PAC ID: 0143132860 Enrollment ID: I20100421000569 |
| Provider Name | Gregory J Ensing |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306856927 PECOS PAC ID: 4587792353 Enrollment ID: I20100514000763 |
| Provider Name | Jamie Lynn Longhurst |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790983609 PECOS PAC ID: 4789714395 Enrollment ID: I20100608000810 |
| Provider Name | Gustavo P Morel |
|---|---|
| Provider Type | Practitioner - Hematology |
| Provider Identifiers | NPI Number: 1104855030 PECOS PAC ID: 5395879746 Enrollment ID: I20100820000099 |
| Provider Name | Rosalind E Griffin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548396567 PECOS PAC ID: 4981738200 Enrollment ID: I20100823000023 |
| Provider Name | Steven D Klamerus |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538159264 PECOS PAC ID: 6901922335 Enrollment ID: I20100923000194 |
| Provider Name | Jason S Duelge |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1326032509 PECOS PAC ID: 2769676667 Enrollment ID: I20101104001119 |
| Provider Name | Lori J Day |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1326258740 PECOS PAC ID: 4385723972 Enrollment ID: I20101112000305 |
| Provider Name | Jay M Lonsway |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1770593741 PECOS PAC ID: 8921293168 Enrollment ID: I20101112000685 |
| Provider Name | Ross F Siemers |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1184716060 PECOS PAC ID: 5597773135 Enrollment ID: I20101113000137 |
| Provider Name | James J Heron |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942364609 PECOS PAC ID: 2769428150 Enrollment ID: I20101119001194 |
| Provider Name | Mary Kay Lehman |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1003882622 PECOS PAC ID: 7315971884 Enrollment ID: I20101130000896 |
| Provider Name | Lynn E Miller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659354298 PECOS PAC ID: 7911194857 Enrollment ID: I20101206000043 |
| Provider Name | Matthew Karulf |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1912109083 PECOS PAC ID: 3971583634 Enrollment ID: I20101209000814 |
| Provider Name | Gregory L Sulik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518929579 PECOS PAC ID: 9739376914 Enrollment ID: I20101214000831 |
| Provider Name | Carol E Gamber |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124001763 PECOS PAC ID: 9931397015 Enrollment ID: I20101216000780 |
| Provider Name | Allan L Olson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255322301 PECOS PAC ID: 0143419192 Enrollment ID: I20110107000571 |
| Provider Name | Howard M Topley |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1669586871 PECOS PAC ID: 9234155623 Enrollment ID: I20110215000152 |
| Provider Name | Muhammad K Koreshi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154546604 PECOS PAC ID: 4486836244 Enrollment ID: I20110315000858 |
| Provider Name | Lynn Robert Hartman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891921631 PECOS PAC ID: 0749464659 Enrollment ID: I20110418000302 |
| Provider Name | Hwan Y Yoo |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1730173436 PECOS PAC ID: 3476542978 Enrollment ID: I20110526000204 |
| Provider Name | Christina D Rose |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1275740847 PECOS PAC ID: 0244417939 Enrollment ID: I20110606000728 |
| Provider Name | Stephen A Vartanian |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1790990919 PECOS PAC ID: 8022296219 Enrollment ID: I20110616000424 |
| Provider Name | Ali N Harb |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1588787808 PECOS PAC ID: 0143408195 Enrollment ID: I20110622000633 |
| Provider Name | Tyanne Dosh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043473655 PECOS PAC ID: 3173719838 Enrollment ID: I20110708000466 |
| Provider Name | Ryan N Hart |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154550721 PECOS PAC ID: 0042489825 Enrollment ID: I20110811000835 |
| Provider Name | Kayleen P Papin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154373090 PECOS PAC ID: 3678504636 Enrollment ID: I20111003000625 |
| Provider Name | Mark Allen Janofski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447548037 PECOS PAC ID: 9335312156 Enrollment ID: I20111024000046 |
| Provider Name | Heather L Busser-demarte |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497034375 PECOS PAC ID: 8426221680 Enrollment ID: I20111103000235 |
| Provider Name | Serge A Sorser |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1033309034 PECOS PAC ID: 8224297940 Enrollment ID: I20120315000218 |
| Provider Name | Amy Martyanov |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1922270768 PECOS PAC ID: 3173681459 Enrollment ID: I20120319000074 |
| Provider Name | Paul G Armour |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1598965717 PECOS PAC ID: 9638335854 Enrollment ID: I20120716000372 |
| Provider Name | Farsad Afshinnia |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1164487161 PECOS PAC ID: 5799701728 Enrollment ID: I20120813000823 |
| Provider Name | Marcin Szember |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1023295300 PECOS PAC ID: 0244488849 Enrollment ID: I20120924000015 |
| Provider Name | Joanna M Olewicz |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1790954097 PECOS PAC ID: 4981890217 Enrollment ID: I20120926000407 |
| Provider Name | Stacey L Cole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063768422 PECOS PAC ID: 3375792856 Enrollment ID: I20120926000611 |
| Provider Name | Eric J Rose |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1235121427 PECOS PAC ID: 4284884503 Enrollment ID: I20121023000477 |
| Provider Name | Gary A Wautier |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801870092 PECOS PAC ID: 4688824733 Enrollment ID: I20121025000481 |
| Provider Name | Angela J Rose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033481684 PECOS PAC ID: 2466605258 Enrollment ID: I20130102000469 |
| Provider Name | Benjamin Thomas Gielda |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1386801496 PECOS PAC ID: 0840460184 Enrollment ID: I20130121000051 |
| Provider Name | William C Hook |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558358077 PECOS PAC ID: 2860645058 Enrollment ID: I20130122000374 |
| Provider Name | Lucas Georgandellis |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1730132580 PECOS PAC ID: 5193786358 Enrollment ID: I20130211000173 |
| Provider Name | George M Nidiffer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336131556 PECOS PAC ID: 4688829807 Enrollment ID: I20130219000293 |
| Provider Name | Kimberly M Thomsen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942309778 PECOS PAC ID: 7911902580 Enrollment ID: I20130311000328 |
| Provider Name | Yazan Khouri |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1154654861 PECOS PAC ID: 1850536343 Enrollment ID: I20130404000460 |
| Provider Name | Asad Mehboob |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1245465152 PECOS PAC ID: 3173768678 Enrollment ID: I20130405000037 |
| Provider Name | Ashly Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285910984 PECOS PAC ID: 0749426575 Enrollment ID: I20130423000163 |
| Provider Name | Jonathan R Harbin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174734750 PECOS PAC ID: 6204998040 Enrollment ID: I20130531000518 |
| Provider Name | Mariana L Perinot |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740591908 PECOS PAC ID: 0143462705 Enrollment ID: I20130809000552 |
| Provider Name | Chelsea Ray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023370624 PECOS PAC ID: 6002058526 Enrollment ID: I20130813000842 |
| Provider Name | Tara Loreth Varoni |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265728729 PECOS PAC ID: 1759523111 Enrollment ID: I20130814000495 |
| Provider Name | Matthew Callander |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1568773588 PECOS PAC ID: 7517109812 Enrollment ID: I20130816000110 |
| Provider Name | Timothy John Labonte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154617603 PECOS PAC ID: 4688816853 Enrollment ID: I20130819000171 |
| Provider Name | Thomas J Massie |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1720374275 PECOS PAC ID: 3577705748 Enrollment ID: I20130819000198 |
| Provider Name | Christopher R Faber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417243973 PECOS PAC ID: 7113169251 Enrollment ID: I20130820000270 |
| Provider Name | Pierce C Park |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1477607638 PECOS PAC ID: 5496802118 Enrollment ID: I20130917000213 |
| Provider Name | Gina Cliett |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164697876 PECOS PAC ID: 5193873362 Enrollment ID: I20130920000351 |
| Provider Name | Laura D Leckelt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801232343 PECOS PAC ID: 5799929212 Enrollment ID: I20130923000449 |
| Provider Name | Ricky Allen Meyer |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1700875747 PECOS PAC ID: 1759273782 Enrollment ID: I20130930000236 |
| Provider Name | Diane Begg Young |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1366643587 PECOS PAC ID: 9739350760 Enrollment ID: I20131007001190 |
| Provider Name | Saswat Sahu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790124642 PECOS PAC ID: 9234364605 Enrollment ID: I20131021001784 |
| Provider Name | James A Carothers |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1114110830 PECOS PAC ID: 4981792611 Enrollment ID: I20131023002328 |
| Provider Name | Christopher Mason |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073838017 PECOS PAC ID: 6608029905 Enrollment ID: I20131209000879 |
| Provider Name | Natalie G Relph |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205900412 PECOS PAC ID: 7214087931 Enrollment ID: I20140106000138 |
| Provider Name | Shawn Elizabeth-bott Brown |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184911703 PECOS PAC ID: 4385871581 Enrollment ID: I20140131001979 |
| Provider Name | Joseph A Steele |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1306284005 PECOS PAC ID: 9436380615 Enrollment ID: I20140401002243 |
| Provider Name | Timur C Akinli |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710195391 PECOS PAC ID: 2567635709 Enrollment ID: I20140423000806 |
| Provider Name | Steven C Behrendsen |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1306812656 PECOS PAC ID: 2365494234 Enrollment ID: I20140515001573 |
| Provider Name | Kimberly S Johnson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467682971 PECOS PAC ID: 4082837604 Enrollment ID: I20140528001305 |
| Provider Name | Simone N Cowan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1194987826 PECOS PAC ID: 1850516360 Enrollment ID: I20140625001278 |
| Provider Name | Katie L Fulcher |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1851705727 PECOS PAC ID: 3577789486 Enrollment ID: I20140730001521 |
| Provider Name | Brian Christopher Turner |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1891938890 PECOS PAC ID: 7911149067 Enrollment ID: I20140731001301 |
| Provider Name | Samantha J Haken |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154735850 PECOS PAC ID: 3870710585 Enrollment ID: I20140804000982 |
| Provider Name | Aaron J Cutlip |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376957068 PECOS PAC ID: 7012134745 Enrollment ID: I20140804001440 |
| Provider Name | Tyson Luoma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811301518 PECOS PAC ID: 9032336417 Enrollment ID: I20140807002167 |
| Provider Name | Stephanie Marie Humpula-mcmahon |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245518521 PECOS PAC ID: 8921227638 Enrollment ID: I20140911000727 |
| Provider Name | Samantha A Conklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750798799 PECOS PAC ID: 0345460861 Enrollment ID: I20141006001451 |
| Provider Name | Teri Lynn Reevs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477955276 PECOS PAC ID: 4183844210 Enrollment ID: I20141013000711 |
| Provider Name | Kimberly M Bonetti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174924781 PECOS PAC ID: 6507087277 Enrollment ID: I20141021002939 |
| Provider Name | James P Reinhart |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1174842025 PECOS PAC ID: 2860621133 Enrollment ID: I20141023000026 |
| Provider Name | Richard A Kochis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609040948 PECOS PAC ID: 1850512104 Enrollment ID: I20141030000256 |
| Provider Name | Michelle D Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083015424 PECOS PAC ID: 0345461620 Enrollment ID: I20141030001384 |
| Provider Name | Terence Alost |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013974724 PECOS PAC ID: 6204816671 Enrollment ID: I20141204001240 |
| Provider Name | Mainor R. Antillon-galdamez |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1215962873 PECOS PAC ID: 1759385206 Enrollment ID: I20141219000900 |
| Provider Name | Derek J Falk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073920633 PECOS PAC ID: 7214250133 Enrollment ID: I20141230001143 |
| Provider Name | Rehan A Khan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1811197817 PECOS PAC ID: 1456448109 Enrollment ID: I20150205001152 |
| Provider Name | Stephanie R Little |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457756983 PECOS PAC ID: 6800111691 Enrollment ID: I20150219002103 |
| Provider Name | Alexandra Krot |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1164694584 PECOS PAC ID: 8729304431 Enrollment ID: I20150223001634 |
| Provider Name | Ahmed Baqer Saeed |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1033423744 PECOS PAC ID: 2062645542 Enrollment ID: I20150224001803 |
| Provider Name | Chelsea T Texter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295143865 PECOS PAC ID: 5496071292 Enrollment ID: I20150312002041 |
| Provider Name | Sara L Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841694734 PECOS PAC ID: 0244557700 Enrollment ID: I20150320000538 |
| Provider Name | Grant R Seeger |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1427252014 PECOS PAC ID: 2365593555 Enrollment ID: I20150407000058 |
| Provider Name | Philip Lowry |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1518949080 PECOS PAC ID: 6305838442 Enrollment ID: I20150409001002 |
| Provider Name | Abbas Zagnoon |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1033313028 PECOS PAC ID: 7315073707 Enrollment ID: I20150416000301 |
| Provider Name | Michael Mirzoyan |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1073787545 PECOS PAC ID: 9931230562 Enrollment ID: I20150508000631 |
| Provider Name | Matthew C Hockberger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275931123 PECOS PAC ID: 6406175561 Enrollment ID: I20150512001630 |
| Provider Name | Joel S Goodwin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1659454437 PECOS PAC ID: 4082706304 Enrollment ID: I20150519001043 |
| Provider Name | Vipul Parekh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1831416304 PECOS PAC ID: 0547452898 Enrollment ID: I20150519002492 |
| Provider Name | Bhavesh Shah |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1083658934 PECOS PAC ID: 4183632599 Enrollment ID: I20150707002433 |
| Provider Name | Usman Saeed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710212758 PECOS PAC ID: 1254643059 Enrollment ID: I20150708001333 |
| Provider Name | Sonia G Geschwindt |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1255503991 PECOS PAC ID: 4385867217 Enrollment ID: I20150710001694 |
| Provider Name | Stephanie Rutterbush |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649652298 PECOS PAC ID: 5890008528 Enrollment ID: I20150723007937 |
| Provider Name | Hans J Wolslau |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588825301 PECOS PAC ID: 0345303590 Enrollment ID: I20150724010450 |
| Provider Name | Meghan M Hanna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114301835 PECOS PAC ID: 4880907492 Enrollment ID: I20150724010752 |
| Provider Name | Christopher J O'connor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922480573 PECOS PAC ID: 1951615350 Enrollment ID: I20150729008939 |
| Provider Name | David James Bidle |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1073995718 PECOS PAC ID: 3375857600 Enrollment ID: I20150730013808 |
| Provider Name | Cassie A Bluhm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730561473 PECOS PAC ID: 7012221195 Enrollment ID: I20150803001659 |
| Provider Name | Eric W Toth |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205247665 PECOS PAC ID: 4082834924 Enrollment ID: I20150804003313 |
| Provider Name | Richard R Rattin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1316101462 PECOS PAC ID: 7719116706 Enrollment ID: I20150804004406 |
| Provider Name | James D Vanpopering |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1144336819 PECOS PAC ID: 1355481284 Enrollment ID: I20150924003126 |
| Provider Name | Kathryn Kurtz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306229133 PECOS PAC ID: 8325356231 Enrollment ID: I20150925001903 |
| Provider Name | Daniel E Shumer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780856195 PECOS PAC ID: 4082892955 Enrollment ID: I20150929000128 |
| Provider Name | Todd Tenenholz |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1689761702 PECOS PAC ID: 5890755318 Enrollment ID: I20151013000093 |
| Provider Name | Laura Marie Santoro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568800480 PECOS PAC ID: 8729397674 Enrollment ID: I20151016000608 |
| Provider Name | Michael F Duckwall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568870004 PECOS PAC ID: 5193945046 Enrollment ID: I20151016000979 |
| Provider Name | Robin E Berlin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265628465 PECOS PAC ID: 1951575992 Enrollment ID: I20151022002198 |
| Provider Name | Douglas O Chinn |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1386605194 PECOS PAC ID: 5395879589 Enrollment ID: I20151201000620 |
| Provider Name | Christopher R Richards |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952631715 PECOS PAC ID: 0648401927 Enrollment ID: I20151211001005 |
| Provider Name | Cary E Fechter |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1649235714 PECOS PAC ID: 2567354632 Enrollment ID: I20160107002862 |
| Provider Name | Yvette R Burdick |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265463525 PECOS PAC ID: 1658285697 Enrollment ID: I20160120001737 |
| Provider Name | Jessica L Ramlow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679915375 PECOS PAC ID: 7618110552 Enrollment ID: I20160128000894 |
| Provider Name | William M Mellana |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1710210679 PECOS PAC ID: 0648578187 Enrollment ID: I20160510000107 |
| Provider Name | Ann Marie Skewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104280734 PECOS PAC ID: 0648569897 Enrollment ID: I20160511002576 |
| Provider Name | Amadeo F Sturla |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801183512 PECOS PAC ID: 4284853961 Enrollment ID: I20160607000283 |
| Provider Name | Oluwaseun Davies |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1164779179 PECOS PAC ID: 6002127990 Enrollment ID: I20160617000746 |
| Provider Name | Ashlee E Laplant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043665045 PECOS PAC ID: 8325339013 Enrollment ID: I20160628001482 |
| Provider Name | Sean D Hendren |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871939686 PECOS PAC ID: 1052637246 Enrollment ID: I20160719001720 |
| Provider Name | Jamie E Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134487796 PECOS PAC ID: 3971751595 Enrollment ID: I20160729001813 |
| Provider Name | Viktoria L Koskenoja |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205102852 PECOS PAC ID: 6305091984 Enrollment ID: I20160802000605 |
| Provider Name | James Robert Baer |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1275531493 PECOS PAC ID: 7618979949 Enrollment ID: I20160804000735 |
| Provider Name | Joshua Dykla |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073958278 PECOS PAC ID: 4688804800 Enrollment ID: I20160809001668 |
| Provider Name | Nitin Kumar Gupta |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1568620003 PECOS PAC ID: 0345561064 Enrollment ID: I20160810002238 |
| Provider Name | David Mark Viau |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942543996 PECOS PAC ID: 1052612694 Enrollment ID: I20160818001609 |
| Provider Name | Riley Jon Torreano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699125377 PECOS PAC ID: 7719272269 Enrollment ID: I20160823000326 |
| Provider Name | Kathryn A Lerche |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093165763 PECOS PAC ID: 6002101524 Enrollment ID: I20160823002555 |
| Provider Name | Adam P Butcher |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1225488992 PECOS PAC ID: 2365737897 Enrollment ID: I20160823002913 |
| Provider Name | James J Taylor |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1225087380 PECOS PAC ID: 5991785693 Enrollment ID: I20160824000133 |
| Provider Name | Kasim Kazbay |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1265747489 PECOS PAC ID: 0749279206 Enrollment ID: I20160824000291 |
| Provider Name | Thomas M Kates |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104276872 PECOS PAC ID: 2961797329 Enrollment ID: I20160824000892 |
| Provider Name | Ellie J Barker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972956860 PECOS PAC ID: 6406141746 Enrollment ID: I20160825000351 |
| Provider Name | James W Sawyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316397094 PECOS PAC ID: 7416242573 Enrollment ID: I20160829001201 |
| Provider Name | Jamie S Johnson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861577355 PECOS PAC ID: 3779721899 Enrollment ID: I20160919000195 |
| Provider Name | Thomas T Schmidt |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154696250 PECOS PAC ID: 3870895188 Enrollment ID: I20160922001044 |
| Provider Name | Maria Cristina C Chan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063650315 PECOS PAC ID: 5496889651 Enrollment ID: I20161006000326 |
| Provider Name | Ihab Hammoud |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1538378617 PECOS PAC ID: 0749475549 Enrollment ID: I20161031001778 |
| Provider Name | Jessica Haloskie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356403778 PECOS PAC ID: 5890862288 Enrollment ID: I20161219000334 |
| Provider Name | Kevin M Mcdowell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033651534 PECOS PAC ID: 0941582571 Enrollment ID: I20170116000610 |
| Provider Name | Khaled Rikabi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851375489 PECOS PAC ID: 4284895905 Enrollment ID: I20170213000170 |
| Provider Name | Shayna M Orlich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548792781 PECOS PAC ID: 9638455173 Enrollment ID: I20170417001069 |
| Provider Name | Bradford Blakeman |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1447212113 PECOS PAC ID: 1355253634 Enrollment ID: I20170426000252 |
| Provider Name | Foluke A Otitoju |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1144298167 PECOS PAC ID: 3375565468 Enrollment ID: I20170504001195 |
| Provider Name | Juan Bonilla |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1558327015 PECOS PAC ID: 7012947153 Enrollment ID: I20170516001011 |
| Provider Name | Jeffrey Silver |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1770585978 PECOS PAC ID: 0345326153 Enrollment ID: I20170526001540 |
| Provider Name | Brian K Hudes |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1063488088 PECOS PAC ID: 4789618240 Enrollment ID: I20170530000309 |
| Provider Name | Michael Charles Rondeau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912443839 PECOS PAC ID: 1254608904 Enrollment ID: I20170530002364 |
| Provider Name | Mark Mccubbin |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1831322932 PECOS PAC ID: 4082868997 Enrollment ID: I20170530002479 |
| Provider Name | Margaret Coplin |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1093743551 PECOS PAC ID: 4587636873 Enrollment ID: I20170530002534 |
| Provider Name | Jennifer Bowden |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093911505 PECOS PAC ID: 4587815709 Enrollment ID: I20170601001187 |
| Provider Name | Benjamin Samuel Richards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043751407 PECOS PAC ID: 3971871765 Enrollment ID: I20170620002251 |
| Provider Name | Matthew Indeck |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1124087945 PECOS PAC ID: 1254308299 Enrollment ID: I20170627000600 |
| Provider Name | Jose Luis Pino-y-torres |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1053310672 PECOS PAC ID: 5294625752 Enrollment ID: I20170629000045 |
| Provider Name | Patrick Huffer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871851766 PECOS PAC ID: 4486975083 Enrollment ID: I20170717000310 |
| Provider Name | Asad Ayub |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1033182761 PECOS PAC ID: 9830114958 Enrollment ID: I20170821000405 |
| Provider Name | Erika Marie Mcmahon |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437567252 PECOS PAC ID: 4183842362 Enrollment ID: I20170824002204 |
| Provider Name | James Orlando |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619388592 PECOS PAC ID: 2961722178 Enrollment ID: I20170907000166 |
| Provider Name | Renae Nicole Reisig |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336454875 PECOS PAC ID: 5496043481 Enrollment ID: I20170912002406 |
| Provider Name | Ehizode Udevbulu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477984631 PECOS PAC ID: 3678887635 Enrollment ID: I20180110001177 |
| Provider Name | Kolawole Omodayo Atandeyi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669608436 PECOS PAC ID: 8527222926 Enrollment ID: I20180110001418 |
| Provider Name | Fadi Antaki |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1124127048 PECOS PAC ID: 1658518816 Enrollment ID: I20180129001971 |
| Provider Name | Bennett W Yu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609922343 PECOS PAC ID: 8628060274 Enrollment ID: I20180215001978 |
| Provider Name | Avrille Beverly George |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1770734782 PECOS PAC ID: 8426227331 Enrollment ID: I20180312001382 |
| Provider Name | Edgar J Massabni |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1649236829 PECOS PAC ID: 1153379557 Enrollment ID: I20180703000848 |
| Provider Name | Jessica Rae Pruente |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1619231362 PECOS PAC ID: 7416198445 Enrollment ID: I20180724002204 |
| Provider Name | Catherine Diane Boomus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225250921 PECOS PAC ID: 9133200686 Enrollment ID: I20180816001512 |
| Provider Name | Ryan B Dick-perez |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982962783 PECOS PAC ID: 7719295872 Enrollment ID: I20180920000978 |
| Provider Name | Adam Burri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184893059 PECOS PAC ID: 9638422710 Enrollment ID: I20181019002697 |
| Provider Name | Yasser Salem |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033226303 PECOS PAC ID: 8224070974 Enrollment ID: I20181024001895 |
| Provider Name | Mina I Elnemr |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1760702302 PECOS PAC ID: 2062654460 Enrollment ID: I20181128000240 |
| Provider Name | Miranda Jayne Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659855013 PECOS PAC ID: 6305181249 Enrollment ID: I20181220001228 |
| Provider Name | Shannon Marie Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134601685 PECOS PAC ID: 4981949500 Enrollment ID: I20181228001834 |
| Provider Name | Choudhury S Hasan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1629187752 PECOS PAC ID: 9638336530 Enrollment ID: I20190131000319 |
| Provider Name | Daniel Domingues De Oliveira |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1982687026 PECOS PAC ID: 7315930799 Enrollment ID: I20190404000425 |
| Provider Name | Leonard K Baidoo |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1669444642 PECOS PAC ID: 0345289435 Enrollment ID: I20190502000637 |
| Provider Name | Natalie Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619441730 PECOS PAC ID: 4688917453 Enrollment ID: I20190517001292 |
| Provider Name | Douglas William Kozeluh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427611870 PECOS PAC ID: 8921331315 Enrollment ID: I20190618002041 |
| Provider Name | Bryan Francis Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568931921 PECOS PAC ID: 3971837378 Enrollment ID: I20190618002749 |
| Provider Name | David John Ahonen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447719794 PECOS PAC ID: 4587998950 Enrollment ID: I20190619001898 |
| Provider Name | Douglas Kyle Atchison |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1154732485 PECOS PAC ID: 5496055212 Enrollment ID: I20190715001576 |
| Provider Name | Leah Heron |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528440245 PECOS PAC ID: 3870805161 Enrollment ID: I20190716000651 |
| Provider Name | Bahram Hormozdi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386800266 PECOS PAC ID: 6002051471 Enrollment ID: I20190723002653 |
| Provider Name | Chasity C Caperton |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316109218 PECOS PAC ID: 4981930252 Enrollment ID: I20190724001284 |
| Provider Name | Matthew Thomas Stepanovich |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1346477676 PECOS PAC ID: 5890017727 Enrollment ID: I20190815000340 |
| Provider Name | Leslie M Lemanek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760746903 PECOS PAC ID: 5799099719 Enrollment ID: I20190816002738 |
| Provider Name | Jonathon Wayne Schwake |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1245436732 PECOS PAC ID: 7214192228 Enrollment ID: I20191001002736 |
| Provider Name | Jacob M Hakkola |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437592250 PECOS PAC ID: 7911202049 Enrollment ID: I20191004001070 |
| Provider Name | Ryann Elizabeth Sohaney |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1790103042 PECOS PAC ID: 1658596606 Enrollment ID: I20191017000571 |
| Provider Name | Thomas Edward Kelly |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1598071201 PECOS PAC ID: 5991925737 Enrollment ID: I20191026000093 |
| Provider Name | Maria Samantha Barreras |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215591359 PECOS PAC ID: 1850623554 Enrollment ID: I20191030000940 |
| Provider Name | Valerie J Taglione |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1437712551 PECOS PAC ID: 1052643566 Enrollment ID: I20191104000832 |
| Provider Name | Michael Robert Piggott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740843861 PECOS PAC ID: 7113359100 Enrollment ID: I20191113000532 |
| Provider Name | Brianna Erin Cadigan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952964173 PECOS PAC ID: 9638501166 Enrollment ID: I20191121000225 |
| Provider Name | Alexander J Perry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508417031 PECOS PAC ID: 2567896434 Enrollment ID: I20191231000838 |
| Provider Name | Chauntelle Leigh Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295378909 PECOS PAC ID: 1951736826 Enrollment ID: I20200123000359 |
| Provider Name | Jeffrey Sweers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982139929 PECOS PAC ID: 7214364777 Enrollment ID: I20200221000923 |
| Provider Name | Anthony J Jurecic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730712969 PECOS PAC ID: 4587092226 Enrollment ID: I20200312000397 |
| Provider Name | Edgardo A Crisostomo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730141466 PECOS PAC ID: 0749316974 Enrollment ID: I20200312001742 |
| Provider Name | Kelly A Rose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740824564 PECOS PAC ID: 9931537263 Enrollment ID: I20200319000740 |
| Provider Name | Christine Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467015487 PECOS PAC ID: 8325476385 Enrollment ID: I20200325002342 |
| Provider Name | Andrew D Fellers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184073850 PECOS PAC ID: 8820386725 Enrollment ID: I20200416001396 |
| Provider Name | Rachel Bonsall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073148409 PECOS PAC ID: 7517398258 Enrollment ID: I20200512002764 |
| Provider Name | Maggie Chen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083825509 PECOS PAC ID: 1658463351 Enrollment ID: I20200518002836 |
| Provider Name | Dexter D Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265967665 PECOS PAC ID: 0547536641 Enrollment ID: I20200604000942 |
| Provider Name | John Travis Ludwig |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1215342449 PECOS PAC ID: 5890087134 Enrollment ID: I20200731001428 |
| Provider Name | Kevin T Stephan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942228259 PECOS PAC ID: 3375532153 Enrollment ID: I20200806003292 |
| Provider Name | Lisa L Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003349937 PECOS PAC ID: 8820375124 Enrollment ID: I20200810002059 |
| Provider Name | Danielle Sandstrom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487284758 PECOS PAC ID: 0749606374 Enrollment ID: I20200813001629 |
| Provider Name | Madhu Kiran H Murthy |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1154532927 PECOS PAC ID: 3173690112 Enrollment ID: I20200825002070 |
| Provider Name | Wilman B Olmedo Calderon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457788796 PECOS PAC ID: 7113341462 Enrollment ID: I20201016002061 |
| Provider Name | Raja Gopaldas |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1982849451 PECOS PAC ID: 7911031836 Enrollment ID: I20201119002892 |
| Provider Name | Nathaniel Albrecht |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467853705 PECOS PAC ID: 6406136811 Enrollment ID: I20201214002836 |
| Provider Name | Janet Tsang |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1306038187 PECOS PAC ID: 6800088725 Enrollment ID: I20210225000057 |
| Provider Name | Annette M Artau |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639512429 PECOS PAC ID: 3274765185 Enrollment ID: I20210330000323 |
| Provider Name | Cemil Mehmet Purut |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1013978279 PECOS PAC ID: 7911033949 Enrollment ID: I20210505000443 |
| Provider Name | Andrew Christopher Look |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1659791218 PECOS PAC ID: 3173923752 Enrollment ID: I20210618001423 |
| Provider Name | Joseph Prinsen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790135754 PECOS PAC ID: 7911330832 Enrollment ID: I20210622001079 |
| Provider Name | Meredith Buck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649775149 PECOS PAC ID: 3375890262 Enrollment ID: I20210719001636 |
| Provider Name | Jamie L Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972184646 PECOS PAC ID: 0345643078 Enrollment ID: I20210719003038 |
| Provider Name | James M Crane |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1992865257 PECOS PAC ID: 9133133176 Enrollment ID: I20210721003282 |
| Provider Name | Marnin A Merrick |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1114132818 PECOS PAC ID: 4183719503 Enrollment ID: I20210809001899 |
| Provider Name | Abigail Prentice |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699270280 PECOS PAC ID: 2860741196 Enrollment ID: I20210825001706 |
| Provider Name | Kaitlin M Plager |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1972004315 PECOS PAC ID: 2062760374 Enrollment ID: I20210830002003 |
| Provider Name | Ericka Marie Distefano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639749963 PECOS PAC ID: 3678970613 Enrollment ID: I20210917002408 |
| Provider Name | Casey Le Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932775236 PECOS PAC ID: 0547667586 Enrollment ID: I20210917002677 |
| Provider Name | Peter Georges |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1861699944 PECOS PAC ID: 3375667405 Enrollment ID: I20210920002493 |
| Provider Name | John Toomey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093387235 PECOS PAC ID: 1658779855 Enrollment ID: I20211001000879 |
| Provider Name | Cheryl Ann Davison |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1396824595 PECOS PAC ID: 7618147885 Enrollment ID: I20211011001512 |
| Provider Name | Ashley Ann Parent |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265927560 PECOS PAC ID: 5496099582 Enrollment ID: I20211109002257 |
| Provider Name | Matthew C Fedor |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1235225624 PECOS PAC ID: 0547294902 Enrollment ID: I20211112001906 |
| Provider Name | Tracy Miles |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1225239106 PECOS PAC ID: 2961539002 Enrollment ID: I20211116001003 |
| Provider Name | David D Beversluis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326363789 PECOS PAC ID: 3476710252 Enrollment ID: I20211230000121 |
| Provider Name | Laura St Onge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528648706 PECOS PAC ID: 4981097375 Enrollment ID: I20220208000112 |
| Provider Name | Spencer L Franchi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154771798 PECOS PAC ID: 0941623938 Enrollment ID: I20220315001914 |
| Provider Name | Ariane Neyou |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1386854073 PECOS PAC ID: 8820140783 Enrollment ID: I20220316001367 |
| Provider Name | David G Cable |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1033183728 PECOS PAC ID: 2567499569 Enrollment ID: I20220505000896 |
| Provider Name | Brian Odom |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730619354 PECOS PAC ID: 0749558369 Enrollment ID: I20220516001953 |
| Provider Name | Elizabeth E Hansen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336700871 PECOS PAC ID: 3870829260 Enrollment ID: I20220531001558 |
| Provider Name | Isaac Thomas Smith |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932669934 PECOS PAC ID: 2466830435 Enrollment ID: I20220602002127 |
| Provider Name | Emily Marie Schmitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114573284 PECOS PAC ID: 3678805496 Enrollment ID: I20220622000409 |
| Provider Name | Connor J Greer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265992580 PECOS PAC ID: 6002233814 Enrollment ID: I20220623000210 |
| Provider Name | Meghan Nicole Digneit |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194454066 PECOS PAC ID: 3476935578 Enrollment ID: I20220805002853 |
| Provider Name | Robin Mann Singh |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1104117670 PECOS PAC ID: 5294002358 Enrollment ID: I20220809002384 |
| Provider Name | Stanley P Kokocki |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1306953633 PECOS PAC ID: 4486621760 Enrollment ID: I20220812001638 |
| Provider Name | Jessica Tripp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154052330 PECOS PAC ID: 2860876158 Enrollment ID: I20220906002078 |
| Provider Name | Pamela R Gordon |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1881629186 PECOS PAC ID: 3779648134 Enrollment ID: I20220917000605 |
| Provider Name | Shelby Lynne Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346961554 PECOS PAC ID: 7012383862 Enrollment ID: I20221019000558 |
| Provider Name | Paul L Wesley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831548494 PECOS PAC ID: 2466745633 Enrollment ID: I20221107000961 |
| Provider Name | Aashish Bhatt |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1790953297 PECOS PAC ID: 8426202680 Enrollment ID: I20221108002736 |
| Provider Name | Robert Kester |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1538103577 PECOS PAC ID: 9133164460 Enrollment ID: I20221108003185 |
| Provider Name | John F Kuhn |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1598729618 PECOS PAC ID: 2062476047 Enrollment ID: I20221109002028 |
| Provider Name | Igal Breitman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1881973014 PECOS PAC ID: 7719121847 Enrollment ID: I20221109002801 |
| Provider Name | Joshua Mccarron |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1801289764 PECOS PAC ID: 4981918729 Enrollment ID: I20221116001180 |
| Provider Name | Joel Poliskey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255960985 PECOS PAC ID: 3072937283 Enrollment ID: I20221117000246 |
| Provider Name | Christopher S Stees |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1063489466 PECOS PAC ID: 3173514916 Enrollment ID: I20221117001023 |
| Provider Name | Marcus Kauffman |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1831201326 PECOS PAC ID: 9436100922 Enrollment ID: I20221123000554 |
| Provider Name | Maygol Sarvi |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1093723777 PECOS PAC ID: 3870548423 Enrollment ID: I20221123001694 |
| Provider Name | Wing C Yeen |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1447474861 PECOS PAC ID: 5991842221 Enrollment ID: I20221202001841 |
| Provider Name | Laura M Ruble |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013369040 PECOS PAC ID: 0042636680 Enrollment ID: I20221205001113 |
| Provider Name | Linda R Belhorn |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1043201692 PECOS PAC ID: 7719028000 Enrollment ID: I20221205001370 |
| Provider Name | Daniel Stroupe |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1003923426 PECOS PAC ID: 3779553334 Enrollment ID: I20221206000735 |
| Provider Name | Christine Matijasic |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1164485868 PECOS PAC ID: 4486668464 Enrollment ID: I20230110000566 |
| Provider Name | John Nnadi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558506782 PECOS PAC ID: 8921138546 Enrollment ID: I20230118000898 |
| Provider Name | Khoa Dang Nguyen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245674159 PECOS PAC ID: 3779784699 Enrollment ID: I20230214002116 |
| Provider Name | Michael Guiou |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1548436363 PECOS PAC ID: 7012151251 Enrollment ID: I20230314001396 |
| Provider Name | Umair Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962982512 PECOS PAC ID: 4880068824 Enrollment ID: I20230315000443 |
| Provider Name | Robert Principato |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1922020262 PECOS PAC ID: 5698660330 Enrollment ID: I20230425002727 |
| Provider Name | Alex Coffman |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1871045690 PECOS PAC ID: 0941604912 Enrollment ID: I20230503003009 |
| Provider Name | Akhil Maheshwari |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962446328 PECOS PAC ID: 3779563978 Enrollment ID: I20230515000807 |
| Provider Name | Lauren Nicole Lemery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184390874 PECOS PAC ID: 4880050723 Enrollment ID: I20230518000580 |
| Provider Name | Maria Nguyen |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1841209194 PECOS PAC ID: 1759336175 Enrollment ID: I20230518002971 |
| Provider Name | Michael Sand |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1932552148 PECOS PAC ID: 6103110820 Enrollment ID: I20230523001717 |
| Provider Name | Aman Patel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1013399286 PECOS PAC ID: 9234437237 Enrollment ID: I20230605000850 |
| Provider Name | Elizabeth A Hogan |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1649690272 PECOS PAC ID: 6608255955 Enrollment ID: I20230608000933 |
| Provider Name | Humberto Jose Rios |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316439987 PECOS PAC ID: 5092135566 Enrollment ID: I20230615000869 |
| Provider Name | Patrick Hughes |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1013995281 PECOS PAC ID: 2668418278 Enrollment ID: I20230627002536 |
| Provider Name | Eric M Schaff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245735463 PECOS PAC ID: 1850633447 Enrollment ID: I20230706002268 |
| Provider Name | Richard J Markiewicz |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1780725580 PECOS PAC ID: 0345279725 Enrollment ID: I20230714002073 |
| Provider Name | Jenna Racine |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225449291 PECOS PAC ID: 3971823659 Enrollment ID: I20230721002101 |
| Provider Name | Ish Singla |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1215111422 PECOS PAC ID: 1254572134 Enrollment ID: I20230725001215 |
| Provider Name | Ryan Meehan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1952745242 PECOS PAC ID: 8527313329 Enrollment ID: I20230727003914 |
| Provider Name | Amy M Slette |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295780013 PECOS PAC ID: 1759308026 Enrollment ID: I20230808000610 |
| Provider Name | Luke A Edwards |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1922361294 PECOS PAC ID: 9537391628 Enrollment ID: I20230809001821 |
| Provider Name | Sara Meehan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790075810 PECOS PAC ID: 4587912126 Enrollment ID: I20230809002677 |
| Provider Name | Alycia Davidson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336765387 PECOS PAC ID: 3678935376 Enrollment ID: I20230811002639 |
| Provider Name | Paige Victoria Schaff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659065878 PECOS PAC ID: 9537523667 Enrollment ID: I20230907004247 |
| Provider Name | Chris Liakonis |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1437117512 PECOS PAC ID: 3779522347 Enrollment ID: I20231116003059 |
| Provider Name | Issam El Bizri |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1013114131 PECOS PAC ID: 8628262144 Enrollment ID: I20240119002663 |
| Provider Name | Nathan D Michels |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396356358 PECOS PAC ID: 6608228853 Enrollment ID: I20240123004372 |
| Provider Name | Joel Terriquez |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1891008884 PECOS PAC ID: 4587813837 Enrollment ID: I20240228000220 |
| Provider Name | Rebekah Sensenig |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1578644985 PECOS PAC ID: 1456597806 Enrollment ID: I20240302000260 |
| Provider Name | Alexis Danielle Perttu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871357970 PECOS PAC ID: 9436594207 Enrollment ID: I20240302000406 |
| Provider Name | Beth Anne-roberts Stanaway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528822327 PECOS PAC ID: 1254778756 Enrollment ID: I20240320000299 |
| Provider Name | Travis Edward Fairbanks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134901846 PECOS PAC ID: 5395182406 Enrollment ID: I20240326000189 |
| Provider Name | Tierra Simmons |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306306006 PECOS PAC ID: 5496100117 Enrollment ID: I20240501001773 |
| Provider Name | Felix Liriano |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619598091 PECOS PAC ID: 4688082456 Enrollment ID: I20240504000081 |
| Provider Name | Michael J Potes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770074114 PECOS PAC ID: 0547525214 Enrollment ID: I20240508003520 |
| Provider Name | Erica Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518428192 PECOS PAC ID: 4880041342 Enrollment ID: I20240509000194 |
| Provider Name | Azmi Ramin Jahan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437683968 PECOS PAC ID: 5496029142 Enrollment ID: I20240521000443 |
| Provider Name | Walid Aziz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417374372 PECOS PAC ID: 5496045767 Enrollment ID: I20240524001119 |
| Provider Name | Nina Mena |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306280664 PECOS PAC ID: 9133465222 Enrollment ID: I20240530001854 |
| Provider Name | Darron Lewis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649767658 PECOS PAC ID: 6406181452 Enrollment ID: I20240614002386 |
Monarch Healthcare Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 545 County Road Hq, Marquette, MI 49855 Phone: 906-273-0072 Fax: 906-273-0559 | |
Marquette Family Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1414 W Fair Ave Ste 249, Marquette, MI 49855 Phone: 906-449-2900 Fax: 906-449-2945 | |
Jeffrey S Karr Mdpc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1414 W Fair Ave, Marquette, MI 49855 Phone: 906-251-0287 | |
Singletrack Health, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 107 W Main St, Suite 2, Marquette, MI 49855 Phone: 906-662-4070 Fax: 906-662-4091 | |
Medical Acne & Skin Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 150 W. Ridge St., Marquette, MI 49855 Phone: 906-235-4486 Fax: 906-680-4077 | |
Heritage Health, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1007 Harbor Hills Dr Ste B, Marquette, MI 49855 Phone: 616-260-0086 | |
Infectious Disease Specialists Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1414 W Fair Ave, Ste 111, Marquette, MI 49855 Phone: 906-225-7601 Fax: 906-225-7453 |