| Wisam Al-mutawalli, MD | |
|
208 Township Blvd, Ste 100, Camillus, NY 13031 | |
| (315) 551-6000 | |
| Not Available |
| Full Name | Wisam Al-mutawalli |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 20 Years |
| Location | 208 Township Blvd, Camillus, New York |
| 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 |
|---|---|---|---|
| 1164005526 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 332191 (New York) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Kindred At Home (liverpool) | Liverpool, NY | Home health agency |
| University Hospital S U N Y Health Science Center | Syracuse, NY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Upstate Family And Preventive Medicine Inc | 6800185711 | 27 |
| Entity Name | Upstate Family And Preventive Medicine Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073988911 PECOS PAC ID: 6800185711 Enrollment ID: O20160517000789 |
| Mailing Address | Practice Location Address |
|---|---|
| Wisam Al-mutawalli, MD 208 Township Blvd, Ste 100, Camillus, NY 13031 Ph: (315) 551-6000 | Wisam Al-mutawalli, MD 208 Township Blvd, Ste 100, Camillus, NY 13031 Ph: (315) 551-6000 |
Thomas J Laclair, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 436 Hinsdale Rd, Camillus, NY 13031 Phone: 315-488-0996 Fax: 315-488-1955 | |
Dennis David Daly, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 5700 W Genesee St, Camillus, NY 13031 Phone: 315-487-1573 Fax: 315-487-2418 | |
James Francis Lawless, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 436 Hinsdale Rd, Camillus, NY 13031 Phone: 315-488-0996 Fax: 315-488-1955 | |
David Thurber Page, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 436 Hinsdale Rd, Camillus, NY 13031 Phone: 315-488-0996 Fax: 315-488-1955 | |
Dr. David Thomas Hope, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 5415 W Genesee St, Suite 301, Camillus, NY 13031 Phone: 315-487-8109 Fax: 315-487-5680 | |
Henry William Schoeneck, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 5700 W Genesee St, Camillus, NY 13031 Phone: 315-487-1573 Fax: 315-487-2418 |