| David Peter Mouallem, DO | |
|
4 E Main St, Nanticoke, PA 18634-1602 | |
| (570) 735-7474 | |
| (570) 735-2921 |
| Full Name | David Peter Mouallem |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 34 Years |
| Location | 4 E Main St, Nanticoke, Pennsylvania |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730132200 | NPI | - | NPPES |
| 0015426480004 | Medicaid | PA | |
| 002460 | Other | PA | FIRST PRIORITY HEALTH |
| 20815 | Other | PA | GEISINGER HEALTH PLAN |
| 787165 | Other | PA | HIGHMARK BLUE SHIELD |
| 787165 | Other | PA | FIRST PRIORITY LIFE |
| 129122 | Other | PA | HEALTH AMERICA |
| 020017400 | Other | PA | BLACK LUNG |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | OS007906L (Pennsylvania) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Commonwealth Home Health & Hospice Of Wilkes-barre | Forty fort, PA | Home health agency |
| Bayada Home Health Care, Inc. | Pittston, PA | Home health agency |
| Compass Home Health And Rehab Llc | Kingston, PA | Home health agency |
| Wilkes-barre General Hospital | Wilkes-barre, PA | Hospital |
| Geisinger Wyoming Valley Medical Center | Wilkes barre, PA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Commonwealth Physician Network Llc | 2668696592 | 62 |
| Phoenix Rehabilitation And Health Services Inc | 3476464298 | 1824 |
| Entity Name | Commonwealth Physician Network Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003238635 PECOS PAC ID: 2668696592 Enrollment ID: O20140617000549 |
| Mailing Address | Practice Location Address |
|---|---|
| David Peter Mouallem, DO 4 E Main St, Nanticoke, PA 18634-1602 Ph: (570) 258-3939 | David Peter Mouallem, DO 4 E Main St, Nanticoke, PA 18634-1602 Ph: (570) 735-7474 |
Jon J Olenginski, DO Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 128 E Main St, Nanticoke, PA 18634 Phone: 570-258-1304 Fax: 570-258-1305 |