| Ms Grace Suyanti Muliawan, PA-C | |
|
611 Clinic Rd, Challis, ID 83226-4824 | |
| (208) 879-4351 | |
| (208) 879-5216 |
| Full Name | Ms Grace Suyanti Muliawan |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 6 Years |
| Location | 611 Clinic Rd, Challis, Idaho |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649879081 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | PA-1991 (Idaho) | Secondary |
| 363A00000X | Physician Assistant | PA-1991 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Steele Memorial Medical Center | Salmon, ID | Hospital |
| St Luke's Regional Medical Center | Boise, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Challis Area Health Center Incorporated | 2769779776 | 8 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Grace Suyanti Muliawan, PA-C Po Box 980, Challis, ID 83226-0980 Ph: (208) 879-4351 | Ms Grace Suyanti Muliawan, PA-C 611 Clinic Rd, Challis, ID 83226-4824 Ph: (208) 879-4351 |
Mr. Kenneth Henry Hyatt, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1 Clinic Road, Challis, ID 83226 Phone: 208-879-4351 Fax: 208-879-5216 | |
Breeann Marie Petrie, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 431 E. Main St. #994, Challis, ID 83226 Phone: 208-833-1313 Fax: 833-839-1195 | |
Mr. Matthew Chad Banks, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 611 Clinic Rd, Challis, ID 83226 Phone: 208-879-4351 Fax: 208-879-5216 | |
Stephen Max Smith, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 611 Clinic Road, Challis, ID 83226 Phone: 208-879-4351 Fax: 208-879-5216 | |
Thomas Daniel Fife, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 611 Clinic Rd, Challis, ID 83226 Phone: 208-879-4351 Fax: 208-879-5216 | |
Miles Alan Haeberle, PHYSICIAN ASSISTANT Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 611 Clinic Rd, Challis, ID 83226 Phone: 208-879-4351 Fax: 208-879-5216 |