| Amanda Prince, | |
|
38882 Mentor Ave, Willoughby, OH 44094-7875 | |
| (440) 953-9999 | |
| Not Available |
| Full Name | Amanda Prince |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 38882 Mentor Ave, Willoughby, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972078483 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 50.005731RX (Ohio) | Primary |
| Entity Name | Signature Health, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679767289 PECOS PAC ID: 8628970985 Enrollment ID: O20040126000762 |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Prince, 38882 Mentor Ave, Willoughby, OH 44094-7875 Ph: (440) 953-9999 | Amanda Prince, 38882 Mentor Ave, Willoughby, OH 44094-7875 Ph: (440) 953-9999 |
Mrs. Bonnie Lynn Broida, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 36000 Euclid Ave, Willoughby, OH 44094 Phone: 440-953-6240 |
George Livingston, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 36000 Euclid Ave, Willoughby, OH 44094 Phone: 440-953-6203 Fax: 440-953-6202 |
Mr. Mark E. Holtcamp, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2785 Som Center Rd, Willoughby, OH 44094 Phone: 440-975-5575 Fax: 440-944-0920 |
Makayla Hudy, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 36000 Euclid Ave, Willoughby, OH 44094 Phone: 440-953-9600 |
Mrs. Joanne T Longbons, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 36100 Euclid Avenue, Suite 170, Willoughby, OH 44094 Phone: 440-602-6737 Fax: 440-942-0316 |
Sydney Wills Mcgiffin, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5105 Som Center Rd Ste 107, Willoughby, OH 44094 Phone: 440-655-8389 |
Schickri Aina, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 36000 Euclid Ave, Willoughby, OH 44094 Phone: 440-953-6203 Fax: 440-953-6202 |