| Mr Michael M Dutkevicz, PA-C | |
|
135 Professional Pl, Bridgeport, WV 26330-4509 | |
| (681) 342-3680 | |
| (681) 342-3665 |
| Full Name | Mr Michael M Dutkevicz |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 135 Professional Pl, Bridgeport, West Virginia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902803331 | NPI | - | NPPES |
| 0070754 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 1809 (West Virginia) | Primary |
| Entity Name | United Hospital Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760965586 PECOS PAC ID: 8123936010 Enrollment ID: O20031212000802 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Michael M Dutkevicz, PA-C 135 Professional Pl, Bridgeport, WV 26330-4509 Ph: (681) 342-3680 | Mr Michael M Dutkevicz, PA-C 135 Professional Pl, Bridgeport, WV 26330-4509 Ph: (681) 342-3680 |
Ms. Heather J Earl, PAC Physician Assistant Medicare: Medicare Enrolled Practice Location: 227 Medical Park Dr Ste 103, Bridgeport, WV 26330 Phone: 681-342-3500 |
Brandy M Straface, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 527 Medical Park Dr Ste 401, Bridgeport, WV 26330 Phone: 681-342-3570 Fax: 681-342-3575 |
Mr. Billy J Bragg, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 215 W Main St, Bridgeport, WV 26330 Phone: 304-842-6645 Fax: 304-842-4909 |
Juilia Barker, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 327 Medical Park Dr, Bridgeport, WV 26330 Phone: 681-342-3660 |
Padraig Kirkwood, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 19 Salisbury Cir, Bridgeport, WV 26330 Phone: 304-709-2386 |
Mandolin Deborah Hoffman-marino, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 135 Professional Place, Bridgeport, WV 26330 Phone: 681-342-3660 Fax: 681-342-3598 |
Patricia Lynn Ross, MPA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 104 Orchard Ave, Bridgeport, WV 26330 Phone: 304-842-8819 |