| Dr Roland Jean Crevecoeur Jr, MD | |
|
1800 N Juniata St, Hollidaysburg, PA 16648-1997 | |
| (814) 695-1675 | |
| (814) 695-0632 |
| Full Name | Dr Roland Jean Crevecoeur Jr |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 1800 N Juniata St, Hollidaysburg, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003912031 | NPI | - | NPPES |
| 110094 | Other | PA | LEGACY PIN |
| P00432632 | Other | PA | RR PIN |
| 001922333 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD419870 (Pennsylvania) | Secondary |
| 208000000X | Pediatrics | MD-419870 (Pennsylvania) | Primary |
| Entity Name | Pennsylvania Department Of Human Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154304483 PECOS PAC ID: 0547168064 Enrollment ID: O20041130000438 |
| Entity Name | Nason Physician Practices Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306236609 PECOS PAC ID: 5890012728 Enrollment ID: O20150402000491 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Roland Jean Crevecoeur Jr, MD 1800 N Juniata St, P O Box 632, Hollidaysburg, PA 16648-1997 Ph: (814) 695-1675 | Dr Roland Jean Crevecoeur Jr, MD 1800 N Juniata St, Hollidaysburg, PA 16648-1997 Ph: (814) 695-1675 |
Aslam M Azad, M.D Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 800 S Logan Blvd, Suite 1200, Hollidaysburg, PA 16648 Phone: 814-946-7568 Fax: 814-943-7490 | |
Dr. Jeevith Isveriya Kumaresan, M.D Pediatrics Medicare: Medicare Enrolled Practice Location: 45 Clover Dr, Hollidaysburg, PA 16648 Phone: 973-930-1075 | |
Kerry Baker, Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 800 S Logan Blvd, Suite 1200, Hollidaysburg, PA 16648 Phone: 814-946-7568 | |
Dr. Mohamed Feizal Zavahir, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1720 N Juniata St, Hollidaysburg, PA 16648 Phone: 814-696-0241 |