| Donald R Brogan, MD | |
|
17 Iron Bridge Dr Ste 100, Collegeville, PA 19426-2042 | |
| (484) 622-6340 | |
| (484) 622-6357 |
| Full Name | Donald R Brogan |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 17 Iron Bridge Dr Ste 100, Collegeville, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679503908 | NPI | - | NPPES |
| 11186981 | Other | PA | MULTIPLAN |
| 36156-MD062087L | Other | PA | HEALTH PARTNERS |
| 370018733 | Other | PA | RRM |
| 509715 | Other | PA | PHCS |
| 0396091000 | Other | PA | AMERIHEALTH/INTERCOUNTY |
| 8816093 | Other | PA | CIGNA HMO/PPO |
| 0396091000 | Other | PA | IBC - PC/KHPE |
| 10923696 | Other | PA | CAQH ID# |
| 5144581 | Other | PA | AETNA PPO |
| 0017431540002 | Medicaid | PA | |
| 0174315401 | Other | PA | AMERICHOICE (UHC MA PLAN) |
| 0858799 | Other | PA | AETNA HMO |
| 1149863 | Other | PA | KEYSTONE MERCY |
| 956785 | Other | PA | HIGHMARK BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | MD062087L (Pennsylvania) | Primary |
| Entity Name | Fornance Physician Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053363523 PECOS PAC ID: 8527962661 Enrollment ID: O20040216000037 |
| Mailing Address | Practice Location Address |
|---|---|
| Donald R Brogan, MD Po Box 789967, Philadelphia, PA 19178-9967 Ph: (484) 622-7395 | Donald R Brogan, MD 17 Iron Bridge Dr Ste 100, Collegeville, PA 19426-2042 Ph: (484) 622-6340 |
Dr. Nicole Kulisek, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 500 Arcola Rd, Collegeville, PA 19426 Phone: 646-942-6148 | |
Elizabeth Ann Filler, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 3770 Ridge Pike, Collegeville, PA 19426 Phone: 484-832-8843 | |
Dr. Peter Bulkeley Langmuir, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1250 S Collegeville Rd, Collegeville, PA 19426 Phone: 215-805-3112 | |
Dr. Larissa F Dominy, D.O. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 409 Second Ave Ste 303, Collegeville, PA 19426 Phone: 610-409-8050 Fax: 610-409-8075 | |
Dr. Perry D Nisen, M.D., PH.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1250 S Collegeville Rd, Up1455, Collegeville, PA 19426 Phone: 610-917-6754 Fax: 610-917-4181 | |
Dr. Gayathri Sudhakar Rao, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 599 Arcola Rd, Nemours Dupont Pediatrics, Collegeville, Collegeville, PA 19426 Phone: 302-651-6660 Fax: 302-651-5345 | |
Shannon L. Vitelli, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 17 Iron Bridge Dr Ste 100, Collegeville, PA 19426 Phone: 484-622-6340 Fax: 484-622-6357 |