| Mr Michael James Davanzo, PA-C | |
|
346 W Goldeneye Ln, Sneads Ferry, NC 28460-8096 | |
| (336) 682-6654 | |
| Not Available |
| Full Name | Mr Michael James Davanzo |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 17 Years |
| Location | 346 W Goldeneye Ln, Sneads Ferry, North Carolina |
| 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 |
|---|---|---|---|
| 1285864991 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 0010-01885 (North Carolina) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Well Care Home Health | Wilmington, NC | Home health agency |
| Novant Health New Hanover Regional Medical Center | Wilmington, NC | Hospital |
| Pender Memorial Hospital | Burgaw, NC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Island Family Medicine Pllc | 8123156445 | 4 |
| Entity Name | Island Family Medicine PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831414150 PECOS PAC ID: 8123156445 Enrollment ID: O20100506000984 |
| Entity Name | Star Medical Clinic PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033565007 PECOS PAC ID: 6800183963 Enrollment ID: O20160919000529 |
| Entity Name | Cdt Healthcare |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700397304 PECOS PAC ID: 2365701596 Enrollment ID: O20180117000292 |
| Entity Name | Brunswick Physician Partners PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457822264 PECOS PAC ID: 2062752470 Enrollment ID: O20190321002645 |
| Entity Name | Piedmont Triad Physicians PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295206464 PECOS PAC ID: 6406197334 Enrollment ID: O20190403000344 |
| Entity Name | Kernersville Emergency Group, PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750852034 PECOS PAC ID: 3375885429 Enrollment ID: O20190422001205 |
| Entity Name | Tanglewood Park Physicians PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093286379 PECOS PAC ID: 3476895129 Enrollment ID: O20190429001041 |
| Entity Name | Fastmed PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629841788 PECOS PAC ID: 9830540558 Enrollment ID: O20240108000613 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Michael James Davanzo, PA-C Po Box 602362, Charlotte, NC 28260-2362 Ph: (336) 765-2500 | Mr Michael James Davanzo, PA-C 346 W Goldeneye Ln, Sneads Ferry, NC 28460-8096 Ph: (336) 682-6654 |
Nicholas John Thibault, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 141 Regatta Way, Sneads Ferry, NC 28460 Phone: 219-689-8493 |