| Wichita Diabetes And Endocrinology, Llc | |
|
8110 E 32nd St N Ste 125 Wichita KS 67226-2644 | |
| (316) 330-3636 | |
| (866) 378-4552 |
| Full Name | Wichita Diabetes And Endocrinology, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 8110 E 32nd St N Ste 125, Wichita, Kansas |
| Authorized Official Name and Position | Aubry Mae Boyce (CLINIC MANAGER) |
| Authorized Official Contact | 3163303636 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wichita Diabetes And Endocrinology, Llc 8110 E 32nd St N Ste 125 Wichita KS 67226-2623 Ph: (316) 330-3636 | Wichita Diabetes And Endocrinology, Llc 8110 E 32nd St N Ste 125 Wichita KS 67226-2644 Ph: (316) 330-3636 |
| NPI Number | 1770080673 |
|---|---|
| Provider Enumeration Date | 04/09/2018 |
| Last Update Date | 11/01/2022 |
| Medicare PECOS PAC ID | 1052675592 |
|---|---|
| Medicare Enrollment ID | O20180508002619 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770080673 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Jolene M Grothe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104025493 PECOS PAC ID: 1850467358 Enrollment ID: I20080908000145 |
| Provider Name | Sahar B Hachem |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1942441357 PECOS PAC ID: 2668529892 Enrollment ID: I20090406000048 |
| Provider Name | Georges C Elhomsy |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1952564908 PECOS PAC ID: 7517100498 Enrollment ID: I20130823001241 |
| Provider Name | Julia A Bippert |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1679904809 PECOS PAC ID: 5395976203 Enrollment ID: I20140318000879 |
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