| Nicholas Dodge, M.d., P.c. | |
|
414 E Drinker St Ste 204 Dunmore PA 18512-2469 | |
| (570) 344-5115 | |
| (570) 344-2123 |
| Full Name | Nicholas Dodge, M.d., P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 414 E Drinker St Ste 204, Dunmore, Pennsylvania |
| Authorized Official Name and Position | Nicholas Dodge (PRESIDENT) |
| Authorized Official Contact | 5703445115 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nicholas Dodge, M.d., P.c. 121 Vosburg Ln Clarks Summit PA 18411-2717 Ph: (570) 344-5115 | Nicholas Dodge, M.d., P.c. 414 E Drinker St Ste 204 Dunmore PA 18512-2469 Ph: (570) 344-5115 |
| NPI Number | 1669669859 |
|---|---|
| Provider Enumeration Date | 10/01/2007 |
| Last Update Date | 12/06/2023 |
| Medicare PECOS PAC ID | 4688620040 |
|---|---|
| Medicare Enrollment ID | O20050329000631 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669669859 | NPI | - | NPPES |
| 1669669859 | Other | PA | NPI |
| 616633 | Other | PA | FIRST PRIORITY LIFE |
| 616633 | Other | PA | AETNA |
| 002981 | Other | PA | FIRST PRIORITY HMO |
| DG7762 | Other | PA | RAILROAD MEDICARE |
| 0763711000 | Other | PA | BLUE CARE / BLUE SHIELD |
| 0015086460006 | Medicaid | PA | |
| 616633 | Other | PA | BLUE SHIELD PA |
| 020395000 | Other | PA | BLACK LUNG |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD054271L (Pennsylvania) | Primary |
| Provider Name | Nicholas D Dodge |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679534226 PECOS PAC ID: 4587789888 Enrollment ID: I20100909000997 |
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