| Mr Peter Omonde Ii, PA | |
|
120 W. Martin Luther Kng Jr. Drive, Washington, NC 27889 | |
| (252) 940-0602 | |
| (252) 940-0605 |
| Full Name | Mr Peter Omonde Ii |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 120 W. Martin Luther Kng Jr. Drive, Washington, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245202738 | NPI | - | NPPES |
| 341871 | Other | NC | FQHC MEDICARE |
| 344591A/344591C | Other | NC | FQHC MEDICAID |
| 344591C | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 102580 (North Carolina) | Primary |
| Entity Name | Metropolitan Community Health Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366488280 PECOS PAC ID: 9931010881 Enrollment ID: O20040630000822 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Peter Omonde Ii, PA 102 N Eden Dr, Washington, NC 27889-3114 Ph: (252) 940-0602 | Mr Peter Omonde Ii, PA 120 W. Martin Luther Kng Jr. Drive, Washington, NC 27889 Ph: (252) 940-0602 |
Ms. Josephine Vida Del Rosario, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 853 Washington Square Mall, Washington, NC 27889 Phone: 252-623-2000 |
Albert Foster Hunt, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 628 E 12th St, Washington, NC 27889 Phone: 252-975-4319 Fax: 252-948-4826 |
David A Baker, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1207 Highland Dr, Washington, NC 27889 Phone: 252-946-6513 Fax: 252-948-0808 |
Bryson Lee, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 853 Washington Square Mall, Washington, NC 27889 Phone: 252-623-2000 |
Stephanie Turnage, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1206 Brown St, Washington, NC 27889 Phone: 252-946-4134 Fax: 252-946-2432 |
Lisa Virginia Wharton, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1412 Carolina Ave, Washington, NC 27889 Phone: 252-623-2000 |
Meredith W Eiban, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 1206 Brown St, Washington, NC 27889 Phone: 252-946-4134 Fax: 252-946-2432 |