Dr Wilfredo A Granada, MD | |
655 Harmon Loop Rd Ste 300, Dededo, GU 96929-6544 | |
(671) 989-6600 | |
(671) 989-8866 |
Full Name | Dr Wilfredo A Granada |
---|---|
Gender | Male |
Speciality | Internal Medicine |
Location | 655 Harmon Loop Rd Ste 300, Dededo, Guam |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851388268 | NPI | - | NPPES |
246401 | Other | IL | MEDICARE |
21604808 | Other | IL | BCBS |
036048709 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 036048709 (Illinois) | Primary |
207R00000X | Internal Medicine | 0023434020 (Wisconsin) | Secondary |
207R00000X | Internal Medicine | M-1973 (Guam) | Secondary |
Entity Name | International Health Providers, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740525278 PECOS PAC ID: 8224279245 Enrollment ID: O20130802000039 |
Entity Name | Takecare Insurance Company Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1972565240 PECOS PAC ID: 8325951239 Enrollment ID: O20140918000062 |
Entity Name | Trinity Healthcare Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1184277873 PECOS PAC ID: 9739410440 Enrollment ID: O20200206001277 |
Mailing Address | Practice Location Address |
---|---|
Dr Wilfredo A Granada, MD Po Box 8838, Tamuning, GU 96931-8838 Ph: (671) 647-5355 | Dr Wilfredo A Granada, MD 655 Harmon Loop Rd Ste 300, Dededo, GU 96929-6544 Ph: (671) 989-6600 |
Leslie Anne Chua, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 133 Route 3, Dededo, GU 96929 Phone: 671-645-5500 | |
Dr. Georgey Easow, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 133 Route 3, Dededo, GU 96929 Phone: 671-645-5500 Fax: 671-645-5549 | |
Dr. Felix T Cabrera, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 655 Harmon Loop Rd Ste 108, Dededo, GU 96929 Phone: 671-633-4447 Fax: 671-633-4452 | |
Michael Calica Agustin, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 133 Route 3, Dededo, GU 96929 Phone: 671-645-5500 Fax: 671-969-4894 | |
Dennis D. Beckworth, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 133 Route 3, Dededo, GU 96929 Phone: 671-645-5546 Fax: 671-645-5549 | |
Dr. Najmeh Akhavan, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 133 Route 3, Dededo, GU 96929 Phone: 671-645-5500 Fax: 671-645-5549 | |
Shadia Santos Constantine, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 133 Route 3, Dededo, GU 96929 Phone: 671-645-5500 |