Susquehanna Health Medical Group | |
145 Shaffer St South Williamsport PA 17702-6727 | |
(570) 326-2447 | |
(570) 326-1247 |
Full Name | Susquehanna Health Medical Group |
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Speciality | Family Medicine |
Location | 145 Shaffer St, South Williamsport, Pennsylvania |
Authorized Official Name and Position | Melissa Davis (VP/COO) |
Authorized Official Contact | 5703207696 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Susquehanna Health Medical Group 1201 Grampian Blvd Williamsport PA 17701-1900 Ph: () - | Susquehanna Health Medical Group 145 Shaffer St South Williamsport PA 17702-6727 Ph: (570) 326-2447 |
NPI Number | 1780631226 |
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Provider Enumeration Date | 05/30/2006 |
Last Update Date | 10/26/2015 |
Medicare PECOS PAC ID | 2264336460 |
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Medicare Enrollment ID | O20040709000444 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780631226 | NPI | - | NPPES |
888650 | Other | PA | HIGHMARK BLUE SHIELD |
0017300760153 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
Provider Name | David Lopatofsky |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1487617155 PECOS PAC ID: 9537204987 Enrollment ID: I20100310000042 |
Provider Name | Michelle L Cavanaugh |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1023082351 PECOS PAC ID: 6103011176 Enrollment ID: I20101116000831 |
Provider Name | Sara E Swain |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1942597281 PECOS PAC ID: 3577709351 Enrollment ID: I20140904002194 |
Provider Name | Brittney Michael Welshans |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679226120 PECOS PAC ID: 1052707684 Enrollment ID: I20220408000037 |
Provider Name | Michael Su |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1639707326 PECOS PAC ID: 6103270517 Enrollment ID: I20231003002526 |
Provider Name | Daniel F Schuler |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1861013682 PECOS PAC ID: 3274957238 Enrollment ID: I20231016003429 |
South Side Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 699 Hastings St, South Williamsport, PA 17702 Phone: 570-327-1335 Fax: 570-321-7800 |