| Dr Mikhail Podlog, DO | |
|
101 Nw 12th Ave Ste 107, Battle Ground, WA 98604-9141 | |
| (360) 723-0528 | |
| (360) 995-0081 |
| Full Name | Dr Mikhail Podlog |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 10 Years |
| Location | 101 Nw 12th Ave Ste 107, Battle Ground, Washington |
| 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 |
|---|---|---|---|
| 1558716746 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 296647 (New York) | Secondary |
| 207P00000X | Emergency Medicine | OP61171512 (Washington) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Peacehealth Southwest Medical Cente | Vancouver, WA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Vital Care, Pllc | 0143712414 | 12 |
| Emergency Medicine Associates Pc | 3870526858 | 37 |
| Entity Name | Emergency Medicine Associates PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962453860 PECOS PAC ID: 3870526858 Enrollment ID: O20050912000784 |
| Entity Name | Vital Care, PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093301418 PECOS PAC ID: 0143712414 Enrollment ID: O20251124003145 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mikhail Podlog, DO 101 Nw 12th Ave Ste 107, Battle Ground, WA 98604-9141 Ph: (360) 723-0528 | Dr Mikhail Podlog, DO 101 Nw 12th Ave Ste 107, Battle Ground, WA 98604-9141 Ph: (360) 723-0528 |
Gary A Smith, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 2005 W Main St, Battle Ground, WA 98604 Phone: 360-397-4060 Fax: 360-666-4772 |
Dr. Terry Ann Moy-brown, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2005 W Main St, Battle Ground, WA 98604 Phone: 360-882-2778 Fax: 360-604-1690 |