| Diana Dawn Dutra, DO | |
|
210 Medical Center Dr, Philipsburg, PA 16866-5500 | |
| (814) 342-5402 | |
| (814) 342-0598 |
| Full Name | Diana Dawn Dutra |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 210 Medical Center Dr, Philipsburg, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477793750 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | OS016007 (Pennsylvania) | Primary |
| Entity Name | Geisinger Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366493868 PECOS PAC ID: 5395657001 Enrollment ID: O20040130000518 |
| Entity Name | Punxsutawney Area Hospital Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1265449870 PECOS PAC ID: 3375517147 Enrollment ID: O20040830000460 |
| Entity Name | Indiana Healthcare Physician Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578523429 PECOS PAC ID: 5294723359 Enrollment ID: O20040927000404 |
| Mailing Address | Practice Location Address |
|---|---|
| Diana Dawn Dutra, DO 100 North Academy Ave, Danville, PA 17822-4903 Ph: (570) 214-5681 | Diana Dawn Dutra, DO 210 Medical Center Dr, Philipsburg, PA 16866-5500 Ph: (814) 342-5402 |
Jennifer L Graham, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 210 Medical Center Dr., Philipsburg, PA 16866 Phone: 814-342-5402 Fax: 814-342-0598 | |
Dr. Satish M. Sawardekar, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 210 Medical Center Dr, Philipsburg, PA 16866 Phone: 814-342-5402 Fax: 814-342-0598 |