| Plaid Eagle Medical Pllc | |
|
3835 Northern Pike Ste 1 Monroeville PA 15146-2132 | |
| (800) 640-3451 | |
| Not Available |
| Full Name | Plaid Eagle Medical Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 3835 Northern Pike Ste 1, Monroeville, Pennsylvania |
| Authorized Official Name and Position | Mariana Hankins (OFFICE ADMINSTRATOR) |
| Authorized Official Contact | 8018881140 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Plaid Eagle Medical Pllc Po Box 1200 Pleasant Grove UT 84062-1200 Ph: (800) 640-3451 | Plaid Eagle Medical Pllc 3835 Northern Pike Ste 1 Monroeville PA 15146-2132 Ph: (800) 640-3451 |
| NPI Number | 1588417117 |
|---|---|
| Provider Enumeration Date | 04/11/2024 |
| Last Update Date | 11/06/2024 |
| Medicare PECOS PAC ID | 6103268560 |
|---|---|
| Medicare Enrollment ID | O20240530002297 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588417117 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Matthew Fackrell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215968045 PECOS PAC ID: 2668400458 Enrollment ID: I20240612001152 |
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