| Sound Physicians | |
|
1512 12th Ave Rd Nampa ID 83686-6008 | |
| (208) 463-5000 | |
| Not Available |
| Full Name | Sound Physicians |
|---|---|
| Speciality | Hospitalist |
| Location | 1512 12th Ave Rd, Nampa, Idaho |
| Authorized Official Name and Position | James Kodjababian (CHIEF REVENUE OFFICER) |
| Authorized Official Contact | 2536821710 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sound Physicians 1123 Pacific Ave Tacoma WA 98402-4303 Ph: (253) 682-1710 | Sound Physicians 1512 12th Ave Rd Nampa ID 83686-6008 Ph: (208) 463-5000 |
| NPI Number | 1730407461 |
|---|---|
| Provider Enumeration Date | 05/05/2010 |
| Last Update Date | 01/23/2015 |
| Medicare PECOS PAC ID | 4688705346 |
|---|---|
| Medicare Enrollment ID | O20100624000921 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730407461 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 208M00000X | Hospitalist | (* (Not Available)) | Primary |
| Provider Name | Barbara A Kammer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306957048 PECOS PAC ID: 9436053980 Enrollment ID: I20031125000725 |
| Provider Name | Mark E Mering |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578527990 PECOS PAC ID: 8022921303 Enrollment ID: I20040405001482 |
| Provider Name | Jonathan L Bowman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497703169 PECOS PAC ID: 1658358098 Enrollment ID: I20040702000417 |
| Provider Name | Steven C Von Flue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871553248 PECOS PAC ID: 0345210969 Enrollment ID: I20040729001084 |
| Provider Name | Michael C Minick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164536728 PECOS PAC ID: 3678580156 Enrollment ID: I20060322000021 |
| Provider Name | James Gardner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730275876 PECOS PAC ID: 8628986452 Enrollment ID: I20061205000135 |
| Provider Name | Stuart Austin Black |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053351361 PECOS PAC ID: 0244233146 Enrollment ID: I20070828000794 |
| Provider Name | William Laitinen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598792863 PECOS PAC ID: 7113010786 Enrollment ID: I20070912000728 |
| Provider Name | Michael G Meza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134124506 PECOS PAC ID: 6901940048 Enrollment ID: I20100212000562 |
| Provider Name | Stephanie K Potter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609892413 PECOS PAC ID: 7315090859 Enrollment ID: I20100615000694 |
| Provider Name | Ryan J Williams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114053014 PECOS PAC ID: 7113000282 Enrollment ID: I20100701000171 |
| Provider Name | Harry Lazarte |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548486053 PECOS PAC ID: 1456424274 Enrollment ID: I20101105001023 |
| Provider Name | James H Rao |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720162365 PECOS PAC ID: 4486620960 Enrollment ID: I20101208000499 |
| Provider Name | Phillip J Redd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134296106 PECOS PAC ID: 3779772181 Enrollment ID: I20110114000646 |
| Provider Name | John J Loffarelli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194728329 PECOS PAC ID: 5890770259 Enrollment ID: I20110823000305 |
| Provider Name | Robert B Buxton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073778098 PECOS PAC ID: 3779625512 Enrollment ID: I20111003000432 |
| Provider Name | Malatesha Gangappa |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1982842019 PECOS PAC ID: 0941473755 Enrollment ID: I20111022000034 |
| Provider Name | Muhammad Kashif Adnan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295991784 PECOS PAC ID: 0042484826 Enrollment ID: I20111111000526 |
| Provider Name | Christoffer A Spoja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003062076 PECOS PAC ID: 4183898281 Enrollment ID: I20111130000459 |
| Provider Name | William Scott Spence |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255351458 PECOS PAC ID: 7719966811 Enrollment ID: I20120612000136 |
| Provider Name | Dhakshayani Sundaralingam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942289780 PECOS PAC ID: 5890753107 Enrollment ID: I20120803000228 |
| Provider Name | Heidi E Shields |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053406488 PECOS PAC ID: 3274627989 Enrollment ID: I20121120000498 |
| Provider Name | Peggie A Bensch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164468187 PECOS PAC ID: 5890683783 Enrollment ID: I20121127000430 |
| Provider Name | Myllissa M Wyatt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730439266 PECOS PAC ID: 8729230503 Enrollment ID: I20121129000501 |
| Provider Name | Ginger L Dattilo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639240864 PECOS PAC ID: 8820184518 Enrollment ID: I20130620000445 |
| Provider Name | Martha Clinton Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417268574 PECOS PAC ID: 7214174184 Enrollment ID: I20130912000401 |
| Provider Name | Patrick D Vargas Villazon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821229279 PECOS PAC ID: 6709010903 Enrollment ID: I20131001000242 |
| Provider Name | Ralene F Wiberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912956806 PECOS PAC ID: 8820224207 Enrollment ID: I20131112002164 |
| Provider Name | Jacob B Jones |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104113562 PECOS PAC ID: 1850519273 Enrollment ID: I20140827001029 |
| Provider Name | Olawale O Olaniyi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881973899 PECOS PAC ID: 6406075688 Enrollment ID: I20140922000000 |
| Provider Name | Jan Rehder King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083038335 PECOS PAC ID: 4880917087 Enrollment ID: I20141219000077 |
| Provider Name | Robert Jordan Lakko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174756340 PECOS PAC ID: 2062648132 Enrollment ID: I20151007000620 |
| Provider Name | Jason R Schwintek |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992864342 PECOS PAC ID: 7810968799 Enrollment ID: I20151022001060 |
| Provider Name | Carson C Bauder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528265949 PECOS PAC ID: 0749335735 Enrollment ID: I20151222000616 |
| Provider Name | Nathan Z Hicks |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1144667817 PECOS PAC ID: 1355668252 Enrollment ID: I20160624001002 |
| Provider Name | Adam R Schwind |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1831539220 PECOS PAC ID: 5597081448 Enrollment ID: I20160725001004 |
| Provider Name | Carolyn G Mcfarlane |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1679802987 PECOS PAC ID: 4082848700 Enrollment ID: I20160929001673 |
| Provider Name | John Bradley Rudolph |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548503022 PECOS PAC ID: 1759604309 Enrollment ID: I20170116000186 |
| Provider Name | Ted Hideki Yamamoto |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689012015 PECOS PAC ID: 2466737960 Enrollment ID: I20170324000712 |
| Provider Name | Cameron J Allen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1730594185 PECOS PAC ID: 4284850215 Enrollment ID: I20170524001125 |
| Provider Name | Pushapdeep K Brar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1699097279 PECOS PAC ID: 0244400109 Enrollment ID: I20170713001851 |
| Provider Name | Cara N Sullivan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912347303 PECOS PAC ID: 0941526800 Enrollment ID: I20170916000632 |
| Provider Name | Jordan D Nugent |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1902224645 PECOS PAC ID: 3274853189 Enrollment ID: I20171128003019 |
| Provider Name | Tejesh Srinivasa Reddy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922312636 PECOS PAC ID: 3476797366 Enrollment ID: I20171128003921 |
| Provider Name | Samantha Lynn Musser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174017701 PECOS PAC ID: 7416204193 Enrollment ID: I20180726001298 |
| Provider Name | Daniel Shih |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790721967 PECOS PAC ID: 7315919156 Enrollment ID: I20190321001082 |
| Provider Name | Emem Idem |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063741221 PECOS PAC ID: 5991957144 Enrollment ID: I20190411003130 |
| Provider Name | Michael Romero |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1801117395 PECOS PAC ID: 2365761798 Enrollment ID: I20190513000315 |
| Provider Name | Niba F Nchotu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366709792 PECOS PAC ID: 3274854153 Enrollment ID: I20190514001307 |
| Provider Name | William Brandenburg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619325180 PECOS PAC ID: 7416240262 Enrollment ID: I20190611003810 |
| Provider Name | Justin Michael Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649633041 PECOS PAC ID: 1557652914 Enrollment ID: I20190619002323 |
| Provider Name | Josef Bartels |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912355462 PECOS PAC ID: 3274826029 Enrollment ID: I20190904000183 |
| Provider Name | Joshua Nadolny |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053763706 PECOS PAC ID: 6103258397 Enrollment ID: I20191108000825 |
| Provider Name | Megan Lenkersdorfer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477197036 PECOS PAC ID: 7315371770 Enrollment ID: I20191231000646 |
| Provider Name | Ermita Bort |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649475120 PECOS PAC ID: 7416041140 Enrollment ID: I20200225001904 |
| Provider Name | Zachary A Weiss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932557782 PECOS PAC ID: 6507159340 Enrollment ID: I20200420001331 |
| Provider Name | Zin M Tun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508122136 PECOS PAC ID: 3779806161 Enrollment ID: I20200508001665 |
| Provider Name | Justin R Tomal |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1093129751 PECOS PAC ID: 3173836244 Enrollment ID: I20200617001933 |
| Provider Name | Klinton Chad Kilgore |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1295267631 PECOS PAC ID: 3678904158 Enrollment ID: I20200819002602 |
| Provider Name | Susheel R Ramasahayam |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366763849 PECOS PAC ID: 8729236864 Enrollment ID: I20201014002465 |
| Provider Name | Ryan Townsend |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285077701 PECOS PAC ID: 6709102866 Enrollment ID: I20201021001135 |
| Provider Name | Brandon L Whitlock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124353719 PECOS PAC ID: 9436572740 Enrollment ID: I20201124003092 |
| Provider Name | James Lee Boysen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699779330 PECOS PAC ID: 9436180916 Enrollment ID: I20210426001939 |
| Provider Name | Evelin Michelle Cruz-gomez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265017206 PECOS PAC ID: 1052712734 Enrollment ID: I20210701002367 |
| Provider Name | Thomas Owen Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538784558 PECOS PAC ID: 8426459058 Enrollment ID: I20210702000306 |
| Provider Name | Lisa Kailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316559073 PECOS PAC ID: 2264847193 Enrollment ID: I20210702000538 |
| Provider Name | Nathaniel Orland Staley |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1316392137 PECOS PAC ID: 1153724604 Enrollment ID: I20210721004149 |
| Provider Name | Mason Heywood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902391857 PECOS PAC ID: 6608115035 Enrollment ID: I20210804004310 |
| Provider Name | Amy M Sprague |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629030598 PECOS PAC ID: 6204882673 Enrollment ID: I20211007001470 |
| Provider Name | Connie Spears |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881228781 PECOS PAC ID: 8123430709 Enrollment ID: I20220531001490 |
| Provider Name | Kristine Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598927931 PECOS PAC ID: 1557535952 Enrollment ID: I20220919001991 |
| Provider Name | Megan Sturdy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033590997 PECOS PAC ID: 3173882958 Enrollment ID: I20230111003076 |
| Provider Name | Megan J Beaudin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992492805 PECOS PAC ID: 9830557974 Enrollment ID: I20230621002213 |
| Provider Name | Whitney A Whitaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669178356 PECOS PAC ID: 9335507375 Enrollment ID: I20230622002647 |
| Provider Name | Sara D Bradley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619664646 PECOS PAC ID: 7618336249 Enrollment ID: I20230629003133 |
| Provider Name | Cassandra Marie Sauther |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154959534 PECOS PAC ID: 0446670277 Enrollment ID: I20230717003560 |
| Provider Name | Neysi J Anderson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124681374 PECOS PAC ID: 7113302886 Enrollment ID: I20230811003146 |
| Provider Name | Augustine Okechukwu Okeke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043572696 PECOS PAC ID: 2567697998 Enrollment ID: I20230817004114 |
| Provider Name | Arash Rafiq |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457792061 PECOS PAC ID: 6103059597 Enrollment ID: I20230818001104 |
| Provider Name | Darsham Gonzalez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235346115 PECOS PAC ID: 1052472701 Enrollment ID: I20230828000370 |
| Provider Name | Kim Mcgrath |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619599347 PECOS PAC ID: 4385067883 Enrollment ID: I20230918001519 |
| Provider Name | Wendy Terese Grace |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265743348 PECOS PAC ID: 3779720693 Enrollment ID: I20230918002705 |
| Provider Name | Helya Peyman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407410731 PECOS PAC ID: 0446614762 Enrollment ID: I20230919003260 |
| Provider Name | Mark Kirk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477180107 PECOS PAC ID: 2567816879 Enrollment ID: I20230921002770 |
| Provider Name | Samantha Renee Eteve |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295363687 PECOS PAC ID: 7012330673 Enrollment ID: I20230926000444 |
| Provider Name | Charlene A Letchford |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427042118 PECOS PAC ID: 3678665171 Enrollment ID: I20231017001894 |
| Provider Name | Wade Butaud |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679703094 PECOS PAC ID: 7012195258 Enrollment ID: I20231019002874 |
| Provider Name | Ahmed Mohamed Abdelhaleem Elsayed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568022473 PECOS PAC ID: 0244561058 Enrollment ID: I20231020002649 |
| Provider Name | Chris P Blaine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952930109 PECOS PAC ID: 5799105193 Enrollment ID: I20231116002447 |
| Provider Name | Haney N Assaad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730119702 PECOS PAC ID: 4385741750 Enrollment ID: I20231120002137 |
| Provider Name | Jerry G Elliott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114152758 PECOS PAC ID: 8527235530 Enrollment ID: I20231120003163 |
| Provider Name | Tyler Ice |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659900736 PECOS PAC ID: 7012330970 Enrollment ID: I20231127000555 |
| Provider Name | Leah Jackson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1730692989 PECOS PAC ID: 9032540141 Enrollment ID: I20231221002372 |
| Provider Name | Nauroz I Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356384325 PECOS PAC ID: 4486657731 Enrollment ID: I20231228002996 |
| Provider Name | Nitin Sainani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952745093 PECOS PAC ID: 8123327921 Enrollment ID: I20231229002998 |
| Provider Name | Mario Seyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942251293 PECOS PAC ID: 0749248623 Enrollment ID: I20240101000269 |
| Provider Name | Shristi Kunwar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497043319 PECOS PAC ID: 1355569435 Enrollment ID: I20240105000257 |
| Provider Name | Jordyn L Watts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548899156 PECOS PAC ID: 6305260563 Enrollment ID: I20240114000078 |
| Provider Name | Adam David Glanzer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932763141 PECOS PAC ID: 4385055441 Enrollment ID: I20240115001941 |
| Provider Name | Justin Carlson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477040939 PECOS PAC ID: 2668716507 Enrollment ID: I20240119003497 |
| Provider Name | Forrest Matt Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821094350 PECOS PAC ID: 5597779942 Enrollment ID: I20240119003582 |
| Provider Name | Raad Al Shaikhli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326433483 PECOS PAC ID: 5698073492 Enrollment ID: I20240214002438 |
| Provider Name | Joseph Gregory Huber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477148443 PECOS PAC ID: 0648670968 Enrollment ID: I20240401001457 |
| Provider Name | Mona Batra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053304634 PECOS PAC ID: 1658319876 Enrollment ID: I20240516001871 |
| Provider Name | Egishe Karapetyan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538785829 PECOS PAC ID: 0749683340 Enrollment ID: I20240521001526 |
| Provider Name | Tao Wang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316472707 PECOS PAC ID: 7416298534 Enrollment ID: I20240523001412 |
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