| Munson Medical Center | |
|
1221 Sixth St Ste 208 Traverse City MI 49684-2360 | |
| (231) 935-2045 | |
| (231) 935-2046 |
| Full Name | Munson Medical Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 1221 Sixth St Ste 208, Traverse City, Michigan |
| Authorized Official Name and Position | Bonnie Kruszka (COO MUNSON PHYSICIAN NETWORK) |
| Authorized Official Contact | 2319354995 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Munson Medical Center 2513 Momentum Pl Chicago IL 60689-5325 Ph: (231) 935-6080 | Munson Medical Center 1221 Sixth St Ste 208 Traverse City MI 49684-2360 Ph: (231) 935-2045 |
| NPI Number | 1083761860 |
|---|---|
| Provider Enumeration Date | 01/04/2007 |
| Last Update Date | 10/04/2024 |
| Medicare PECOS PAC ID | 3072426287 |
|---|---|
| Medicare Enrollment ID | O20040108000904 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083761860 | NPI | - | NPPES |
| 0B81243 | Other | MI | BCBS GROUP |
| 0B86016 | Other | MI | BCBS GROUP NUMBER |
| CB9942 | Other | MI | RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Paula C Colombo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043389273 PECOS PAC ID: 9133033327 Enrollment ID: I20031112000727 |
| Provider Name | Marilyn E Conlon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548373186 PECOS PAC ID: 2961316401 Enrollment ID: I20031118000637 |
| Provider Name | Curtis Albert Cummins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144390980 PECOS PAC ID: 2668386111 Enrollment ID: I20031118000694 |
| Provider Name | John S Stratton |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1447239678 PECOS PAC ID: 2567363971 Enrollment ID: I20040119000378 |
| Provider Name | Todd M Sheperd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679597785 PECOS PAC ID: 5890689459 Enrollment ID: I20040212000879 |
| Provider Name | Thomas M Minnec |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518945211 PECOS PAC ID: 8921994104 Enrollment ID: I20040225000073 |
| Provider Name | Scott B Davidson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1811977424 PECOS PAC ID: 8022920511 Enrollment ID: I20040225001010 |
| Provider Name | Kerry L Kole |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1912996166 PECOS PAC ID: 1850288333 Enrollment ID: I20040301000361 |
| Provider Name | Joseph G Lessard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306891403 PECOS PAC ID: 9234029174 Enrollment ID: I20040316000995 |
| Provider Name | Nathan E March |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467462762 PECOS PAC ID: 6305737586 Enrollment ID: I20040324001585 |
| Provider Name | Patrick H Friedli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255341046 PECOS PAC ID: 0143110239 Enrollment ID: I20040414001368 |
| Provider Name | Tobin J Fraser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336159102 PECOS PAC ID: 5193615284 Enrollment ID: I20040414001425 |
| Provider Name | Douglas L Mckay |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215980073 PECOS PAC ID: 8729074364 Enrollment ID: I20040421000450 |
| Provider Name | Thomas L Mcelwee |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1285673863 PECOS PAC ID: 6901894070 Enrollment ID: I20040505001567 |
| Provider Name | James M Fox |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1740275379 PECOS PAC ID: 9931198520 Enrollment ID: I20040510000215 |
| Provider Name | Montgomery Hegewald |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1205902095 PECOS PAC ID: 9335130830 Enrollment ID: I20040522000261 |
| Provider Name | Timothy P Madion |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1689628497 PECOS PAC ID: 5496746984 Enrollment ID: I20040609000322 |
| Provider Name | Marcy Verplanck-kanitz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245282631 PECOS PAC ID: 6406847995 Enrollment ID: I20040609000344 |
| Provider Name | Laura J Danz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1104870963 PECOS PAC ID: 1850382342 Enrollment ID: I20040609000436 |
| Provider Name | Richard M Beck |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750446902 PECOS PAC ID: 1658354253 Enrollment ID: I20040612000151 |
| Provider Name | Thomas Charles Nussdorfer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134124662 PECOS PAC ID: 2668454547 Enrollment ID: I20040714001114 |
| Provider Name | Mark V Galan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1023184819 PECOS PAC ID: 1355320250 Enrollment ID: I20040715000098 |
| Provider Name | Kersti M Bruining |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558364315 PECOS PAC ID: 8224018320 Enrollment ID: I20040721000105 |
| Provider Name | Roberto Andres Corpus |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1417995432 PECOS PAC ID: 7416937982 Enrollment ID: I20040723001078 |
| Provider Name | David C Rushlow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245414200 PECOS PAC ID: 3072587369 Enrollment ID: I20040823000995 |
| Provider Name | Howard J Beck |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1427037613 PECOS PAC ID: 4284609959 Enrollment ID: I20040827000262 |
| Provider Name | Todd Allan Myers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245333558 PECOS PAC ID: 4082689757 Enrollment ID: I20040827000267 |
| Provider Name | Brian E Woodruff |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215921432 PECOS PAC ID: 3476529066 Enrollment ID: I20040903001185 |
| Provider Name | Thomas C Schermerhorn |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1518962026 PECOS PAC ID: 9436126331 Enrollment ID: I20040910001031 |
| Provider Name | Debra J Kurtz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184674616 PECOS PAC ID: 2769450253 Enrollment ID: I20040923000062 |
| Provider Name | Katharine M Julian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528145265 PECOS PAC ID: 9032187430 Enrollment ID: I20040923000278 |
| Provider Name | Robert E Kuhn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104818681 PECOS PAC ID: 6608844659 Enrollment ID: I20040923000889 |
| Provider Name | Diana L Novak |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053362186 PECOS PAC ID: 1355319633 Enrollment ID: I20040923001003 |
| Provider Name | Andrew H Teklinski |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1336160555 PECOS PAC ID: 2769451996 Enrollment ID: I20040924001050 |
| Provider Name | Loren M Wise |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972573442 PECOS PAC ID: 3274592688 Enrollment ID: I20041008001435 |
| Provider Name | Cornelius Robens |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538158688 PECOS PAC ID: 7214999036 Enrollment ID: I20041103000101 |
| Provider Name | Lucille A Grietsell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235210642 PECOS PAC ID: 6103889035 Enrollment ID: I20041110001210 |
| Provider Name | Elizabeth Shannon Elliot |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013919109 PECOS PAC ID: 5496718389 Enrollment ID: I20041111000251 |
| Provider Name | James R Mackenzie |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1043260102 PECOS PAC ID: 0042209306 Enrollment ID: I20041208000607 |
| Provider Name | David M Kam |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1518981679 PECOS PAC ID: 8729044862 Enrollment ID: I20041209000590 |
| Provider Name | Xiaoping Huang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346343449 PECOS PAC ID: 2769378496 Enrollment ID: I20050107000800 |
| Provider Name | Lynn L Swan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972680411 PECOS PAC ID: 2365491222 Enrollment ID: I20050119000122 |
| Provider Name | Steven T Deroos |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528033990 PECOS PAC ID: 2769436393 Enrollment ID: I20050308000171 |
| Provider Name | Jay Adam Starr |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1912998477 PECOS PAC ID: 6608822416 Enrollment ID: I20050324000727 |
| Provider Name | Deborah A Warren |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043315492 PECOS PAC ID: 8325095532 Enrollment ID: I20050331000131 |
| Provider Name | Renae L Vaughn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518923093 PECOS PAC ID: 0749227924 Enrollment ID: I20050408000967 |
| Provider Name | Ryan P Mcconnell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285625301 PECOS PAC ID: 1658316484 Enrollment ID: I20050622001097 |
| Provider Name | Lynne Mccormick |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1194779983 PECOS PAC ID: 5496790917 Enrollment ID: I20050624000880 |
| Provider Name | David Darwin Nicolaou |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184676181 PECOS PAC ID: 7911943154 Enrollment ID: I20050628001221 |
| Provider Name | Bobby Kipak Kong |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1013943083 PECOS PAC ID: 1951337534 Enrollment ID: I20050714000776 |
| Provider Name | Edward E Newcomb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750373437 PECOS PAC ID: 2062448673 Enrollment ID: I20050714000965 |
| Provider Name | Kim G Lee |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1861587602 PECOS PAC ID: 6305872631 Enrollment ID: I20050721000138 |
| Provider Name | Michael J Peters |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1982628848 PECOS PAC ID: 1658308457 Enrollment ID: I20050723000118 |
| Provider Name | Ahmet Sevimli |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1912096629 PECOS PAC ID: 3375572621 Enrollment ID: I20050808000661 |
| Provider Name | Brent M Wiersema |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1790709632 PECOS PAC ID: 7113988106 Enrollment ID: I20050815000280 |
| Provider Name | Stephanie M Morreale |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1386608875 PECOS PAC ID: 8820040553 Enrollment ID: I20051103000689 |
| Provider Name | Kurt Alan Wright |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275576258 PECOS PAC ID: 3971522905 Enrollment ID: I20051118000065 |
| Provider Name | Natalie S Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427053529 PECOS PAC ID: 2668487067 Enrollment ID: I20060207000113 |
| Provider Name | David J Straight |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760487805 PECOS PAC ID: 5597770800 Enrollment ID: I20060208000111 |
| Provider Name | Kevin Clayton |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1528053188 PECOS PAC ID: 1951316157 Enrollment ID: I20060209000085 |
| Provider Name | Mark Arthur Elliott |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1184619744 PECOS PAC ID: 3173538386 Enrollment ID: I20060209000140 |
| Provider Name | Richard David Entz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407854185 PECOS PAC ID: 8527073733 Enrollment ID: I20060209000155 |
| Provider Name | Lawrence H Warbasse |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902801327 PECOS PAC ID: 4486606613 Enrollment ID: I20060209000218 |
| Provider Name | Stuart L Warnaar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245235472 PECOS PAC ID: 4981619103 Enrollment ID: I20060209000246 |
| Provider Name | Richard A Woodbury |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1497750814 PECOS PAC ID: 7517919749 Enrollment ID: I20060209000292 |
| Provider Name | Anne Hepner |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1023003738 PECOS PAC ID: 4284649419 Enrollment ID: I20060209000320 |
| Provider Name | Brian David Jaffe |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1063407799 PECOS PAC ID: 7416962659 Enrollment ID: I20060209000371 |
| Provider Name | Steven Michael Lamie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013909217 PECOS PAC ID: 0941215180 Enrollment ID: I20060209000393 |
| Provider Name | James G Milliken |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1467459867 PECOS PAC ID: 4981619137 Enrollment ID: I20060209000526 |
| Provider Name | Dino Recchia |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1992790547 PECOS PAC ID: 9739178310 Enrollment ID: I20060209000556 |
| Provider Name | Carl B Anders |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194779843 PECOS PAC ID: 8921013806 Enrollment ID: I20060214000332 |
| Provider Name | Natalie Ann Gray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124116108 PECOS PAC ID: 6709831613 Enrollment ID: I20060222000855 |
| Provider Name | Russel D Jelsema |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588654263 PECOS PAC ID: 9234192907 Enrollment ID: I20060302000687 |
| Provider Name | Deborah Cheryl Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710926027 PECOS PAC ID: 8325055932 Enrollment ID: I20060307000412 |
| Provider Name | John Beattie |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1265428718 PECOS PAC ID: 4688681224 Enrollment ID: I20060307000686 |
| Provider Name | Paula Susan Meyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760434682 PECOS PAC ID: 3971515792 Enrollment ID: I20060619000146 |
| Provider Name | Peter W Springsteen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265438790 PECOS PAC ID: 0840191482 Enrollment ID: I20060628000132 |
| Provider Name | Jan J Vlach |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962408393 PECOS PAC ID: 6800878786 Enrollment ID: I20060628000150 |
| Provider Name | Dana L Hoffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992749279 PECOS PAC ID: 9638182736 Enrollment ID: I20060712000268 |
| Provider Name | Sarah R Seaver |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245281252 PECOS PAC ID: 8123022126 Enrollment ID: I20060906000135 |
| Provider Name | Christopher R Chuinard |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1205926268 PECOS PAC ID: 5092713768 Enrollment ID: I20061114000252 |
| Provider Name | Lisa Allred |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386716223 PECOS PAC ID: 0042219149 Enrollment ID: I20061219000510 |
| Provider Name | Glen H Henbest |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1154476828 PECOS PAC ID: 0648373902 Enrollment ID: I20070307000503 |
| Provider Name | David M Calder |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750425682 PECOS PAC ID: 7416051586 Enrollment ID: I20070329000185 |
| Provider Name | Julie J Page |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1528108180 PECOS PAC ID: 9931205838 Enrollment ID: I20070510000121 |
| Provider Name | Susan M Elben |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942381983 PECOS PAC ID: 3577660828 Enrollment ID: I20070521000462 |
| Provider Name | Amy S Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669559399 PECOS PAC ID: 7214034313 Enrollment ID: I20070524000556 |
| Provider Name | Roger K Gerstle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285792754 PECOS PAC ID: 3870693260 Enrollment ID: I20070713000768 |
| Provider Name | Charles R Klettner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760441646 PECOS PAC ID: 0345341483 Enrollment ID: I20070719000597 |
| Provider Name | Susan Lanser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740280965 PECOS PAC ID: 6800987041 Enrollment ID: I20070802000344 |
| Provider Name | David S Gordon |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1477519940 PECOS PAC ID: 0648361402 Enrollment ID: I20070808000246 |
| Provider Name | Brian J Kerr |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1407940190 PECOS PAC ID: 2466459201 Enrollment ID: I20070814000061 |
| Provider Name | Andrew S Boyce |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1275637811 PECOS PAC ID: 6305941048 Enrollment ID: I20070814000068 |
| Provider Name | Camille J Griswold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437139318 PECOS PAC ID: 7012001134 Enrollment ID: I20070920000430 |
| Provider Name | Richard N Tooley |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1295727824 PECOS PAC ID: 7012907330 Enrollment ID: I20071022000298 |
| Provider Name | Michael A Nizzi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1700802055 PECOS PAC ID: 5193701944 Enrollment ID: I20071022000364 |
| Provider Name | Roche J Featherstone |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1215958673 PECOS PAC ID: 3779573001 Enrollment ID: I20071022000379 |
| Provider Name | Tae Hwa Chun |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1124144019 PECOS PAC ID: 3476640616 Enrollment ID: I20071105000086 |
| Provider Name | Kamala Wright |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1144278656 PECOS PAC ID: 7911095971 Enrollment ID: I20071109000018 |
| Provider Name | Lucinda S Geiser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922151158 PECOS PAC ID: 8921196015 Enrollment ID: I20071127000385 |
| Provider Name | Peter C Kohler |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1477520872 PECOS PAC ID: 9638259047 Enrollment ID: I20080110000102 |
| Provider Name | Susan F Corwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750430948 PECOS PAC ID: 1254415813 Enrollment ID: I20080221000310 |
| Provider Name | Nancy G Cutler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285693838 PECOS PAC ID: 8628152634 Enrollment ID: I20080229000362 |
| Provider Name | Zachary Hector Word |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1316064041 PECOS PAC ID: 1557446051 Enrollment ID: I20080307000414 |
| Provider Name | Kendra G Worden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972772259 PECOS PAC ID: 7517044100 Enrollment ID: I20080407000515 |
| Provider Name | Anna M Booher |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1205954765 PECOS PAC ID: 9335226729 Enrollment ID: I20080409000635 |
| Provider Name | Toni Renee Gaultier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467445619 PECOS PAC ID: 4385722289 Enrollment ID: I20080417000249 |
| Provider Name | Richard G Smith |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1093938193 PECOS PAC ID: 1052499415 Enrollment ID: I20080425000044 |
| Provider Name | David P Michelin |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1831180140 PECOS PAC ID: 5496834541 Enrollment ID: I20080501000049 |
| Provider Name | David J Bradley |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1184703654 PECOS PAC ID: 8426014986 Enrollment ID: I20080520000317 |
| Provider Name | Monica M Goble |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1922119049 PECOS PAC ID: 6406926906 Enrollment ID: I20080609000882 |
| Provider Name | Patricia A Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538131396 PECOS PAC ID: 3476624032 Enrollment ID: I20080625000503 |
| Provider Name | Andrew J Weise |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447469291 PECOS PAC ID: 3375615313 Enrollment ID: I20080708000253 |
| Provider Name | Hal R Yost |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801820154 PECOS PAC ID: 9335212067 Enrollment ID: I20080714000535 |
| Provider Name | John R Reineck |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1205995057 PECOS PAC ID: 2961575584 Enrollment ID: I20080715000758 |
| Provider Name | Andrea S Russell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992803795 PECOS PAC ID: 6406920339 Enrollment ID: I20080811000332 |
| Provider Name | Jeremy D Barber |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1417177866 PECOS PAC ID: 1254406937 Enrollment ID: I20080814000253 |
| Provider Name | Aditya Pandey |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1184825200 PECOS PAC ID: 7911007646 Enrollment ID: I20080816000029 |
| Provider Name | John Joseph Gorman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487646923 PECOS PAC ID: 9032146246 Enrollment ID: I20080827000238 |
| Provider Name | Heather K Lee |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871754085 PECOS PAC ID: 7911073895 Enrollment ID: I20080828000375 |
| Provider Name | Anthony B Ochoa |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1720060395 PECOS PAC ID: 7911073945 Enrollment ID: I20080829000559 |
| Provider Name | Kari L Young |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780850941 PECOS PAC ID: 8224106356 Enrollment ID: I20081002000525 |
| Provider Name | Renae L Preston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417105800 PECOS PAC ID: 5698833382 Enrollment ID: I20081024000267 |
| Provider Name | Neeraj Chaudhary |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1265684450 PECOS PAC ID: 2466512488 Enrollment ID: I20081120000834 |
| Provider Name | Kipp Chillag |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1518931245 PECOS PAC ID: 1052471844 Enrollment ID: I20081124000666 |
| Provider Name | Diana Curran |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831156165 PECOS PAC ID: 9234026642 Enrollment ID: I20081209000300 |
| Provider Name | David E Oakley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578523700 PECOS PAC ID: 7810051752 Enrollment ID: I20090121000661 |
| Provider Name | Jacques Brett Burgess |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1174549802 PECOS PAC ID: 6103980560 Enrollment ID: I20090129000349 |
| Provider Name | Adam L Dorfman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1386615391 PECOS PAC ID: 9739116252 Enrollment ID: I20090129000388 |
| Provider Name | Wilfred P Saldanha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326141532 PECOS PAC ID: 6103983275 Enrollment ID: I20090318000167 |
| Provider Name | Eugene Zolotarevsky |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1508989633 PECOS PAC ID: 8527125301 Enrollment ID: I20090323000253 |
| Provider Name | David A Simpson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1912996265 PECOS PAC ID: 1850448630 Enrollment ID: I20090414000263 |
| Provider Name | Andrew P Bone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639194244 PECOS PAC ID: 0446307086 Enrollment ID: I20090416000370 |
| Provider Name | Anne M Pawlak |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1891784484 PECOS PAC ID: 6406899954 Enrollment ID: I20090521000314 |
| Provider Name | John P Macnowski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316066806 PECOS PAC ID: 5294885307 Enrollment ID: I20090611000385 |
| Provider Name | Todd R Adams |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1144433277 PECOS PAC ID: 5193876886 Enrollment ID: I20090618000721 |
| Provider Name | Brian A Lishawa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154334399 PECOS PAC ID: 0547311508 Enrollment ID: I20090702000265 |
| Provider Name | Benjamin G Lamphere |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1407064009 PECOS PAC ID: 5496809360 Enrollment ID: I20090812000692 |
| Provider Name | Catherine Bluteau Stoddard |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1376756643 PECOS PAC ID: 5193879674 Enrollment ID: I20090818000535 |
| Provider Name | David K Klee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497763809 PECOS PAC ID: 6709881600 Enrollment ID: I20090902000697 |
| Provider Name | James D Zeratsky |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235246919 PECOS PAC ID: 0345396511 Enrollment ID: I20090914000641 |
| Provider Name | April E Kurkowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891994026 PECOS PAC ID: 3274689211 Enrollment ID: I20090916000728 |
| Provider Name | Jessica L Slocum |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1144342262 PECOS PAC ID: 8628118528 Enrollment ID: I20091229000135 |
| Provider Name | Kimberly B Augenstein |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1760431340 PECOS PAC ID: 1355482514 Enrollment ID: I20100109000330 |
| Provider Name | Paul T Turner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811992571 PECOS PAC ID: 8628077120 Enrollment ID: I20100215000368 |
| Provider Name | Joseph W Rawlin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306904842 PECOS PAC ID: 5799810990 Enrollment ID: I20100312000585 |
| Provider Name | Clark Edward Nugent |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1902993769 PECOS PAC ID: 0547395204 Enrollment ID: I20100319000220 |
| Provider Name | Joseph M Mcgraw |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1225052186 PECOS PAC ID: 8426048505 Enrollment ID: I20100320000092 |
| Provider Name | Bailey S Groseclose |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1730103680 PECOS PAC ID: 1557497989 Enrollment ID: I20100324001161 |
| Provider Name | Mark C Chames |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750474961 PECOS PAC ID: 4880636273 Enrollment ID: I20100325001040 |
| Provider Name | Ward R Gillett |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1053302562 PECOS PAC ID: 1052301322 Enrollment ID: I20100326000522 |
| Provider Name | Chester L Pflugrad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467541870 PECOS PAC ID: 9739144676 Enrollment ID: I20100326000744 |
| Provider Name | Erin C Beaton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477876050 PECOS PAC ID: 0648307389 Enrollment ID: I20100428000684 |
| Provider Name | Timothy Ray Lambert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386734366 PECOS PAC ID: 8426186172 Enrollment ID: I20100517000765 |
| Provider Name | Glen N Ackerman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1912060633 PECOS PAC ID: 7012046865 Enrollment ID: I20100603000672 |
| Provider Name | Mark David Richardson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669449443 PECOS PAC ID: 9133259401 Enrollment ID: I20100612000069 |
| Provider Name | Daniel R Fain |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1922088491 PECOS PAC ID: 4486784329 Enrollment ID: I20100618000793 |
| Provider Name | Daniel M Webster |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164571493 PECOS PAC ID: 1153452032 Enrollment ID: I20100622000561 |
| Provider Name | Neesha E Fournier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194988402 PECOS PAC ID: 6507923208 Enrollment ID: I20100702000430 |
| Provider Name | Julia Anne Riddle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275785578 PECOS PAC ID: 0244363224 Enrollment ID: I20100727000938 |
| Provider Name | F Matthew Smith |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1285614032 PECOS PAC ID: 6103894688 Enrollment ID: I20100728001013 |
| Provider Name | Richard G Burke |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1427039072 PECOS PAC ID: 3678568185 Enrollment ID: I20100830000380 |
| Provider Name | Jeni Kay Wares |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1447405816 PECOS PAC ID: 7214052935 Enrollment ID: I20100917000192 |
| Provider Name | William B Chung |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1467458992 PECOS PAC ID: 9032301247 Enrollment ID: I20101006000789 |
| Provider Name | Richard G Faller |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174529606 PECOS PAC ID: 9436341641 Enrollment ID: I20101006000856 |
| Provider Name | Olufemi O Soyode |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1184735698 PECOS PAC ID: 9931391760 Enrollment ID: I20101012000167 |
| Provider Name | Mary K Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366461121 PECOS PAC ID: 8224221684 Enrollment ID: I20101019000461 |
| Provider Name | Erica L Oakley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104022334 PECOS PAC ID: 8921292111 Enrollment ID: I20101102000127 |
| Provider Name | Peter T Bump |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1447214937 PECOS PAC ID: 0840216263 Enrollment ID: I20101105000530 |
| Provider Name | Dennis Sula |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1699781658 PECOS PAC ID: 0244235059 Enrollment ID: I20101109000441 |
| Provider Name | Kelly J Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487806717 PECOS PAC ID: 8921293531 Enrollment ID: I20101110000163 |
| Provider Name | Tracy Lynne Riddle |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1669594024 PECOS PAC ID: 6608062542 Enrollment ID: I20101118000309 |
| Provider Name | Nicklaus K Slocum |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1295873388 PECOS PAC ID: 3375739097 Enrollment ID: I20101119001207 |
| Provider Name | William P Potthoff |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760475818 PECOS PAC ID: 6103899554 Enrollment ID: I20101208001212 |
| Provider Name | Jean Mcdonough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295035244 PECOS PAC ID: 1052509015 Enrollment ID: I20101217000629 |
| Provider Name | Marylee Pakieser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265517494 PECOS PAC ID: 7911995972 Enrollment ID: I20110113001084 |
| Provider Name | Diane Donley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366461212 PECOS PAC ID: 5698955870 Enrollment ID: I20110204000345 |
| Provider Name | Matthew C Salon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730163528 PECOS PAC ID: 2062692163 Enrollment ID: I20110207000710 |
| Provider Name | Bradley K Evans |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1255356523 PECOS PAC ID: 7911187034 Enrollment ID: I20110207000909 |
| Provider Name | Howard M Topley |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1669586871 PECOS PAC ID: 9234155623 Enrollment ID: I20110215000152 |
| Provider Name | James M Howard |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1841304961 PECOS PAC ID: 1052337441 Enrollment ID: I20110215000192 |
| Provider Name | Thomas J Yax |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104078419 PECOS PAC ID: 7416135736 Enrollment ID: I20110708000432 |
| Provider Name | Justin J Hollander |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1053538868 PECOS PAC ID: 0042489734 Enrollment ID: I20110815000573 |
| Provider Name | Kevin L Schneider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982729299 PECOS PAC ID: 1456521848 Enrollment ID: I20110822000276 |
| Provider Name | Mark Cannon |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1881805265 PECOS PAC ID: 4587747522 Enrollment ID: I20110926000367 |
| Provider Name | Heather A Sowinski |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700036274 PECOS PAC ID: 0648446302 Enrollment ID: I20111229000621 |
| Provider Name | Kevin M Omilusik |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679579122 PECOS PAC ID: 4183670219 Enrollment ID: I20120125000952 |
| Provider Name | Nancy L Giffels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114202140 PECOS PAC ID: 1557528205 Enrollment ID: I20120207000780 |
| Provider Name | Rachel E Soles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033480769 PECOS PAC ID: 7012175003 Enrollment ID: I20120222000348 |
| Provider Name | Christina A Plamondon |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1851662779 PECOS PAC ID: 6002076080 Enrollment ID: I20120328000974 |
| Provider Name | Jacqueline B Plamondon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255617619 PECOS PAC ID: 5294999595 Enrollment ID: I20120618000708 |
| Provider Name | Craig T Kuesel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1013925080 PECOS PAC ID: 7911162664 Enrollment ID: I20120629000546 |
| Provider Name | Shan E Abbas |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730362674 PECOS PAC ID: 5597920272 Enrollment ID: I20120702000303 |
| Provider Name | Erica Ann Austin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477715076 PECOS PAC ID: 2668638719 Enrollment ID: I20120718000467 |
| Provider Name | Rickie Lloyd Edgar |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1275748212 PECOS PAC ID: 3173789872 Enrollment ID: I20120725000172 |
| Provider Name | Christopher S Ledtke |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1356517734 PECOS PAC ID: 0547426140 Enrollment ID: I20120726000298 |
| Provider Name | Marshall T Poole |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1144482712 PECOS PAC ID: 1850547522 Enrollment ID: I20120813000210 |
| Provider Name | Thomas E Hartwig |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982865382 PECOS PAC ID: 1052567468 Enrollment ID: I20120816000857 |
| Provider Name | Robert O Kennedy |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1457485948 PECOS PAC ID: 9638326994 Enrollment ID: I20120822000314 |
| Provider Name | Kristen N Maurice |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1730343583 PECOS PAC ID: 7911154943 Enrollment ID: I20120828000051 |
| Provider Name | Vivian C Romero Romero |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245432368 PECOS PAC ID: 7719135011 Enrollment ID: I20120911000619 |
| Provider Name | Mark Douglas Norris |
|---|---|
| Provider Type | Practitioner - Adult Congenital Heart Disease (achd) |
| Provider Identifiers | NPI Number: 1720290513 PECOS PAC ID: 2860592375 Enrollment ID: I20120921000620 |
| Provider Name | Christopher M Donzell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780932137 PECOS PAC ID: 5092964585 Enrollment ID: I20120926000636 |
| Provider Name | Shelly C Lall |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1740235886 PECOS PAC ID: 3971515206 Enrollment ID: I20121011000488 |
| Provider Name | Andrew J Riddle |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1215059670 PECOS PAC ID: 8527219286 Enrollment ID: I20121107000119 |
| Provider Name | Mara L Mckinley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518244912 PECOS PAC ID: 1456503754 Enrollment ID: I20121213000302 |
| Provider Name | Michael Howe |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1114127198 PECOS PAC ID: 2860671633 Enrollment ID: I20130207000364 |
| Provider Name | Margaret A Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629358627 PECOS PAC ID: 8022262278 Enrollment ID: I20130216000071 |
| Provider Name | Alison B Quiring |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245522994 PECOS PAC ID: 7416195011 Enrollment ID: I20130521000047 |
| Provider Name | Joshua M Ruch |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1770746257 PECOS PAC ID: 1052558053 Enrollment ID: I20130717000466 |
| Provider Name | Lisa A Stier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265774269 PECOS PAC ID: 1759522915 Enrollment ID: I20130730000952 |
| Provider Name | Rachel H Plum |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447480934 PECOS PAC ID: 3375786288 Enrollment ID: I20130826000035 |
| Provider Name | Ashley N Sachtleben |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1891950317 PECOS PAC ID: 3577706142 Enrollment ID: I20130829000411 |
| Provider Name | Adrian S Seah |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1306966908 PECOS PAC ID: 7719120203 Enrollment ID: I20130903000175 |
| Provider Name | Aaron J Heindl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457663361 PECOS PAC ID: 5597908905 Enrollment ID: I20130904000892 |
| Provider Name | Linda Gossett |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1306985338 PECOS PAC ID: 3274685052 Enrollment ID: I20130905000095 |
| Provider Name | Matthew J Shullick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912246513 PECOS PAC ID: 5395989735 Enrollment ID: I20130925000119 |
| Provider Name | Thomas V Ohagan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1124273958 PECOS PAC ID: 4183858269 Enrollment ID: I20131002000603 |
| Provider Name | Diane Begg Young |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1366643587 PECOS PAC ID: 9739350760 Enrollment ID: I20131007001190 |
| Provider Name | Abbigale J E Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760702161 PECOS PAC ID: 7214161686 Enrollment ID: I20131018000533 |
| Provider Name | Jenifer L Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619180064 PECOS PAC ID: 4183723992 Enrollment ID: I20131019000192 |
| Provider Name | Joanna T Heindl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619105269 PECOS PAC ID: 6305071986 Enrollment ID: I20131107000688 |
| Provider Name | Shamarie J Regenold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831521996 PECOS PAC ID: 2961638390 Enrollment ID: I20131113001491 |
| Provider Name | Heather D Frankle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093157091 PECOS PAC ID: 4789810086 Enrollment ID: I20131114001656 |
| Provider Name | Haley A. Owen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275975286 PECOS PAC ID: 6406083724 Enrollment ID: I20131212000629 |
| Provider Name | Nicole J Fliss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346270865 PECOS PAC ID: 3971551300 Enrollment ID: I20140116001693 |
| Provider Name | Alissa A O'hagan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1376874040 PECOS PAC ID: 2769650407 Enrollment ID: I20140121000568 |
| Provider Name | Diana E Okuniewski |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184831547 PECOS PAC ID: 8729245915 Enrollment ID: I20140131001431 |
| Provider Name | Molly Kidner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083035521 PECOS PAC ID: 5890970479 Enrollment ID: I20140301000065 |
| Provider Name | Nicole K Gill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093865032 PECOS PAC ID: 4284818634 Enrollment ID: I20140306001408 |
| Provider Name | Thomas Robert Harding |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194837336 PECOS PAC ID: 8527075787 Enrollment ID: I20140310000136 |
| Provider Name | Kimberly Sue Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386942837 PECOS PAC ID: 1153552120 Enrollment ID: I20140317000852 |
| Provider Name | Nicole L Tramontini |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1447223631 PECOS PAC ID: 2860643541 Enrollment ID: I20140527000867 |
| Provider Name | Tami Jean Hiser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467740878 PECOS PAC ID: 2264604099 Enrollment ID: I20140617002423 |
| Provider Name | John W Polley |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1477534931 PECOS PAC ID: 5698840601 Enrollment ID: I20140620000470 |
| Provider Name | Andrew C Luea |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1154558104 PECOS PAC ID: 8022232644 Enrollment ID: I20140620001157 |
| Provider Name | Seth Devries |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1518128974 PECOS PAC ID: 9032335518 Enrollment ID: I20140717002262 |
| Provider Name | Kathryn S Shaffer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487940631 PECOS PAC ID: 4688890494 Enrollment ID: I20140730001840 |
| Provider Name | Nicholas S Parmer |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1194131912 PECOS PAC ID: 8820215395 Enrollment ID: I20140806001378 |
| Provider Name | Patrick H Dillon |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1952531683 PECOS PAC ID: 5092932848 Enrollment ID: I20140819000710 |
| Provider Name | Todd L Galdes |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1376703868 PECOS PAC ID: 6406095470 Enrollment ID: I20140828001256 |
| Provider Name | Megan L Burroughs |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376830190 PECOS PAC ID: 7113145038 Enrollment ID: I20140905001107 |
| Provider Name | Anna Theresa Stone |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1497054951 PECOS PAC ID: 1153553946 Enrollment ID: I20141002001034 |
| Provider Name | Anastasia Luniova |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942461447 PECOS PAC ID: 8325277213 Enrollment ID: I20141013002133 |
| Provider Name | Andrea M Dunklow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053713479 PECOS PAC ID: 9133173495 Enrollment ID: I20141031002018 |
| Provider Name | Yasser Al-khatib |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1053311779 PECOS PAC ID: 3971580705 Enrollment ID: I20150129002304 |
| Provider Name | Colleen Sabatine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326481920 PECOS PAC ID: 9830415793 Enrollment ID: I20150311002676 |
| Provider Name | Thomas C Andrews |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1841238151 PECOS PAC ID: 2769668359 Enrollment ID: I20150402002390 |
| Provider Name | Roman Antonio Barraza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770803355 PECOS PAC ID: 7315266566 Enrollment ID: I20150513001280 |
| Provider Name | Erik Lindstrom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265793590 PECOS PAC ID: 3779804893 Enrollment ID: I20150602000403 |
| Provider Name | Christopher A Lafond |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083930465 PECOS PAC ID: 6608025515 Enrollment ID: I20150625000443 |
| Provider Name | Barbara S Ames |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598155020 PECOS PAC ID: 7214249374 Enrollment ID: I20150701001838 |
| Provider Name | John L Coatney |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1518286046 PECOS PAC ID: 4789996323 Enrollment ID: I20150709002715 |
| Provider Name | Sarah Ellen Stearns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598146516 PECOS PAC ID: 0244543718 Enrollment ID: I20150714000341 |
| Provider Name | Joseph Kuruvilla |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962667667 PECOS PAC ID: 6002129061 Enrollment ID: I20150720002042 |
| Provider Name | Caitlin Kelly Schmidt |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1699068148 PECOS PAC ID: 8628382009 Enrollment ID: I20150729007979 |
| Provider Name | Eric B Lerche |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1225264005 PECOS PAC ID: 9436377645 Enrollment ID: I20150806010950 |
| Provider Name | Glen Macpherson |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1467429050 PECOS PAC ID: 0446387252 Enrollment ID: I20150806011036 |
| Provider Name | Stacey M Steeno |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1356724702 PECOS PAC ID: 6305150152 Enrollment ID: I20150806012028 |
| Provider Name | Yelena E Kier |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1659532034 PECOS PAC ID: 9335329358 Enrollment ID: I20150825003547 |
| Provider Name | Mark E Oppenlander |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1033373998 PECOS PAC ID: 6204143639 Enrollment ID: I20150917002297 |
| Provider Name | Jeffrey C Magnatta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417216854 PECOS PAC ID: 5799093357 Enrollment ID: I20150930002447 |
| Provider Name | Charles Vandenberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750638516 PECOS PAC ID: 6305155029 Enrollment ID: I20151020003017 |
| Provider Name | Melissa Schaub |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255702999 PECOS PAC ID: 8921308669 Enrollment ID: I20151201003151 |
| Provider Name | Alainna Vander Ark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700120185 PECOS PAC ID: 3375846041 Enrollment ID: I20160129001923 |
| Provider Name | Scott T Maurer |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1760437891 PECOS PAC ID: 2062663115 Enrollment ID: I20160208000889 |
| Provider Name | Julie Comfort |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215308036 PECOS PAC ID: 3476857533 Enrollment ID: I20160210000634 |
| Provider Name | Stephen R Ereg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235504945 PECOS PAC ID: 8123323888 Enrollment ID: I20160218000927 |
| Provider Name | Michaela Coffia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003276197 PECOS PAC ID: 4880991447 Enrollment ID: I20160324001736 |
| Provider Name | Kristin E Betts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699137760 PECOS PAC ID: 7517265713 Enrollment ID: I20160420001612 |
| Provider Name | Sheena Meredith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437516135 PECOS PAC ID: 1759670680 Enrollment ID: I20160517001462 |
| Provider Name | Tara D Bournay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487090718 PECOS PAC ID: 4284924820 Enrollment ID: I20160609001417 |
| Provider Name | Evan C Tank |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1124316054 PECOS PAC ID: 9931417813 Enrollment ID: I20160623000568 |
| Provider Name | Jonathan E Bott |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1245523174 PECOS PAC ID: 5799095113 Enrollment ID: I20160708001049 |
| Provider Name | Deborah Poineau |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093954489 PECOS PAC ID: 4183916398 Enrollment ID: I20160708001100 |
| Provider Name | Joseph P Ward |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1902127764 PECOS PAC ID: 5294968665 Enrollment ID: I20160711000375 |
| Provider Name | Gwendolyn M Gravelie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093058737 PECOS PAC ID: 1355654872 Enrollment ID: I20160712001665 |
| Provider Name | Jena Krueger |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679898357 PECOS PAC ID: 8527350289 Enrollment ID: I20160718000389 |
| Provider Name | Jonathan E Beaulac |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1508132283 PECOS PAC ID: 6901039973 Enrollment ID: I20160722001225 |
| Provider Name | Hilarion H Bibicoff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114367703 PECOS PAC ID: 6406166628 Enrollment ID: I20160728000381 |
| Provider Name | Shoba S Ryan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730539149 PECOS PAC ID: 0648564229 Enrollment ID: I20160804000531 |
| Provider Name | Amber Gall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033569587 PECOS PAC ID: 9335433887 Enrollment ID: I20160808000228 |
| Provider Name | Stephanie N. Allers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366895617 PECOS PAC ID: 9436443702 Enrollment ID: I20160809001962 |
| Provider Name | Dawn Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548612666 PECOS PAC ID: 3577857770 Enrollment ID: I20160811000289 |
| Provider Name | Kristian M Koller |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1760793368 PECOS PAC ID: 6305130238 Enrollment ID: I20160816000100 |
| Provider Name | Stephanie D Markle |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992937403 PECOS PAC ID: 9931326196 Enrollment ID: I20160818000182 |
| Provider Name | Aimee Hennessy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336591478 PECOS PAC ID: 2163717430 Enrollment ID: I20160825001101 |
| Provider Name | Matthew G Arnold |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376854653 PECOS PAC ID: 8426344185 Enrollment ID: I20160906001272 |
| Provider Name | Justine D Pearl |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1093260929 PECOS PAC ID: 1153618103 Enrollment ID: I20160920000929 |
| Provider Name | Cheryl Walch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609229665 PECOS PAC ID: 4486941036 Enrollment ID: I20160926000100 |
| Provider Name | Joel A Strehl |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1780971614 PECOS PAC ID: 0749509453 Enrollment ID: I20161005002071 |
| Provider Name | Keith Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891729398 PECOS PAC ID: 6507099256 Enrollment ID: I20161006000306 |
| Provider Name | Patricia Alsgaard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336382993 PECOS PAC ID: 9032268065 Enrollment ID: I20161006001211 |
| Provider Name | Amber L Wisniewski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952602856 PECOS PAC ID: 4486942059 Enrollment ID: I20161013002266 |
| Provider Name | Joseph J Gibbs |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1053654665 PECOS PAC ID: 2163654229 Enrollment ID: I20161017000477 |
| Provider Name | Kathryn F Krezoski Evans |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194136721 PECOS PAC ID: 5597043448 Enrollment ID: I20161027000023 |
| Provider Name | Ethan Braden Morrical |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376954917 PECOS PAC ID: 6204115306 Enrollment ID: I20161114000100 |
| Provider Name | Kenneth Maliq Louis |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1093736639 PECOS PAC ID: 5395937130 Enrollment ID: I20161116001443 |
| Provider Name | Angel W Hernandez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457444531 PECOS PAC ID: 0749187516 Enrollment ID: I20161208000403 |
| Provider Name | Kevin M Mcdowell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033651534 PECOS PAC ID: 0941582571 Enrollment ID: I20170116000610 |
| Provider Name | Rueben Adekunle Adegoke |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134380470 PECOS PAC ID: 5799972592 Enrollment ID: I20170119000259 |
| Provider Name | Elizabeth A Kessler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649492802 PECOS PAC ID: 3375854292 Enrollment ID: I20170124000939 |
| Provider Name | Samantha K Windle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013328640 PECOS PAC ID: 2062796147 Enrollment ID: I20170309001849 |
| Provider Name | Lena J Widman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730560970 PECOS PAC ID: 6103101316 Enrollment ID: I20170329002701 |
| Provider Name | Jennifer A Marsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780026849 PECOS PAC ID: 8628203890 Enrollment ID: I20170413000831 |
| Provider Name | Edward J Bergeron |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1477753952 PECOS PAC ID: 2062644933 Enrollment ID: I20170522002575 |
| Provider Name | Jennifer G Emmons |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1932549086 PECOS PAC ID: 1153640859 Enrollment ID: I20170613001968 |
| Provider Name | Allison M Goldsmith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023351731 PECOS PAC ID: 5698905594 Enrollment ID: I20170627002497 |
| Provider Name | Melissa E Bibicoff |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144560251 PECOS PAC ID: 5597997684 Enrollment ID: I20170630000399 |
| Provider Name | Stanley Sedore |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306163092 PECOS PAC ID: 5193011450 Enrollment ID: I20170706001597 |
| Provider Name | Oliver E Aregullin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275882599 PECOS PAC ID: 4789953688 Enrollment ID: I20170710000752 |
| Provider Name | Emily Annette Dryer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437579992 PECOS PAC ID: 4183933013 Enrollment ID: I20170713002873 |
| Provider Name | David J Hobbs |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1174886279 PECOS PAC ID: 3971731019 Enrollment ID: I20170714001454 |
| Provider Name | Michael Donald Katona |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174043889 PECOS PAC ID: 6204109382 Enrollment ID: I20170912002269 |
| Provider Name | Robert Sprunk |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962480814 PECOS PAC ID: 3072427269 Enrollment ID: I20170912003295 |
| Provider Name | John A Campbell |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1427153329 PECOS PAC ID: 0749372134 Enrollment ID: I20170929002186 |
| Provider Name | Gregory M Francisco |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1447222831 PECOS PAC ID: 4880850833 Enrollment ID: I20171025001637 |
| Provider Name | Laura Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124564836 PECOS PAC ID: 1850657909 Enrollment ID: I20171107000767 |
| Provider Name | Jessica E. Paonessa |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1386760122 PECOS PAC ID: 2567601495 Enrollment ID: I20171211002961 |
| Provider Name | Deborah Strand |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346754843 PECOS PAC ID: 4789942137 Enrollment ID: I20171213001153 |
| Provider Name | Murtadha Abdulhussein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316280738 PECOS PAC ID: 0547529752 Enrollment ID: I20180116002018 |
| Provider Name | Wendy M Whitfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295285583 PECOS PAC ID: 1850674706 Enrollment ID: I20180213002627 |
| Provider Name | Eryn Hart |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184808651 PECOS PAC ID: 3072557388 Enrollment ID: I20180222000528 |
| Provider Name | Valleri L Raupp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952777153 PECOS PAC ID: 4587925672 Enrollment ID: I20180306002883 |
| Provider Name | Michelle Q Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235327214 PECOS PAC ID: 9638430663 Enrollment ID: I20180307001684 |
| Provider Name | Jordon Alexander Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467954784 PECOS PAC ID: 2466715164 Enrollment ID: I20180411000524 |
| Provider Name | Adam Pinney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639529290 PECOS PAC ID: 9335403039 Enrollment ID: I20180504001224 |
| Provider Name | Brian David Hesler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699949370 PECOS PAC ID: 6709178932 Enrollment ID: I20180531002557 |
| Provider Name | Brittnee L Keyes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700374378 PECOS PAC ID: 7214282011 Enrollment ID: I20180619003004 |
| Provider Name | Jonathan A Ducastel |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1073956694 PECOS PAC ID: 0749419422 Enrollment ID: I20180620001740 |
| Provider Name | Aimee H Dereczyk |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972921757 PECOS PAC ID: 8921304189 Enrollment ID: I20180621000287 |
| Provider Name | Christopher Michael Archangeli |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972948602 PECOS PAC ID: 3971898222 Enrollment ID: I20180702002397 |
| Provider Name | Molly A Britton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891113148 PECOS PAC ID: 8921321290 Enrollment ID: I20180711000432 |
| Provider Name | Dianna L Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497023832 PECOS PAC ID: 9739436288 Enrollment ID: I20180716001907 |
| Provider Name | Margaret Hartmann |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831554740 PECOS PAC ID: 8527315084 Enrollment ID: I20180716002457 |
| Provider Name | Eric Dale Buras |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1336587237 PECOS PAC ID: 2365758471 Enrollment ID: I20180720002368 |
| Provider Name | Jay E Dujon |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1578734158 PECOS PAC ID: 0749456242 Enrollment ID: I20180725000234 |
| Provider Name | Annabelle K Dampier |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164785614 PECOS PAC ID: 5193038966 Enrollment ID: I20180725000317 |
| Provider Name | Barrett A Kielhorn |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1750720132 PECOS PAC ID: 2961645890 Enrollment ID: I20180803002558 |
| Provider Name | Natalie L Ducastel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588150460 PECOS PAC ID: 7618226531 Enrollment ID: I20180824002285 |
| Provider Name | Andrew J Riegel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649685108 PECOS PAC ID: 8123324357 Enrollment ID: I20180904001958 |
| Provider Name | Osama Kashlan |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1144549940 PECOS PAC ID: 0446565469 Enrollment ID: I20180911002628 |
| Provider Name | Gihan E. Dawood |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1255489746 PECOS PAC ID: 6800845447 Enrollment ID: I20180913001318 |
| Provider Name | Holly Jo Hinds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346733268 PECOS PAC ID: 5698026045 Enrollment ID: I20180924001940 |
| Provider Name | Matthew J Dubiel |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1114280898 PECOS PAC ID: 7911135256 Enrollment ID: I20181008001654 |
| Provider Name | Anamarie Gronsman-francis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497890487 PECOS PAC ID: 4385996933 Enrollment ID: I20181009001693 |
| Provider Name | Karri Hagan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013490663 PECOS PAC ID: 4284987090 Enrollment ID: I20181024002733 |
| Provider Name | Amber Ristow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801361407 PECOS PAC ID: 9335483072 Enrollment ID: I20181206000458 |
| Provider Name | Laura Ann Christopher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558839696 PECOS PAC ID: 5799029104 Enrollment ID: I20181211002584 |
| Provider Name | David Sung-wook Moon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164866414 PECOS PAC ID: 2769727064 Enrollment ID: I20181214000167 |
| Provider Name | John William Stanifer |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1427373232 PECOS PAC ID: 5294038725 Enrollment ID: I20190116001297 |
| Provider Name | Fazeel Mukhtar Siddiqui |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154513687 PECOS PAC ID: 0345475331 Enrollment ID: I20190513001577 |
| Provider Name | Georgia Olga Pozios |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013449859 PECOS PAC ID: 4486997863 Enrollment ID: I20190529000516 |
| Provider Name | Alexander Weick |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1942542444 PECOS PAC ID: 0648402693 Enrollment ID: I20190605002442 |
| Provider Name | Clinton D. Cochran |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194161612 PECOS PAC ID: 0547576878 Enrollment ID: I20190613000669 |
| Provider Name | Kelly Bedford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396279469 PECOS PAC ID: 1456686088 Enrollment ID: I20190718000604 |
| Provider Name | Heather Elizabeth Carroll |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1902246689 PECOS PAC ID: 6103136304 Enrollment ID: I20190718001113 |
| Provider Name | Shelly Marie Dale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982266896 PECOS PAC ID: 2365778073 Enrollment ID: I20190801001096 |
| Provider Name | Leah Walbridge |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720515190 PECOS PAC ID: 0345577029 Enrollment ID: I20190805001305 |
| Provider Name | Shawn Ann Kintigh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639638588 PECOS PAC ID: 4486982030 Enrollment ID: I20190821001657 |
| Provider Name | Shruti Sevak |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194088468 PECOS PAC ID: 9537391644 Enrollment ID: I20190823000661 |
| Provider Name | Katie Lynn Mowers |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609142959 PECOS PAC ID: 3274883608 Enrollment ID: I20190827000623 |
| Provider Name | Roy Jonathan Golden |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1538455738 PECOS PAC ID: 3375845142 Enrollment ID: I20190830001074 |
| Provider Name | Hannah Popa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457913337 PECOS PAC ID: 9739418898 Enrollment ID: I20190916000771 |
| Provider Name | Annmarie D Egan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558717330 PECOS PAC ID: 0547591091 Enrollment ID: I20191014002883 |
| Provider Name | Linda Barbara Pauliks |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013903947 PECOS PAC ID: 7618881160 Enrollment ID: I20191126000091 |
| Provider Name | Lindsey Marie Ranstadler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033674072 PECOS PAC ID: 3375970114 Enrollment ID: I20200217004268 |
| Provider Name | Karie Lynn Llewellyn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942763164 PECOS PAC ID: 7618304478 Enrollment ID: I20200218000654 |
| Provider Name | Amanda Radocy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750911434 PECOS PAC ID: 2961830526 Enrollment ID: I20200312001499 |
| Provider Name | Sara Virginia Sniff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932749249 PECOS PAC ID: 3971931239 Enrollment ID: I20200319001948 |
| Provider Name | Shannon Marie Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871143685 PECOS PAC ID: 2365871209 Enrollment ID: I20200329000366 |
| Provider Name | Sherry L Joanette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811522980 PECOS PAC ID: 8325478761 Enrollment ID: I20200425000056 |
| Provider Name | Gary Rajah |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1457616849 PECOS PAC ID: 4981905676 Enrollment ID: I20200511002776 |
| Provider Name | Junewai L Reoma |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1285753111 PECOS PAC ID: 5193968766 Enrollment ID: I20200515000189 |
| Provider Name | Derek E Pyne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184116873 PECOS PAC ID: 3779904883 Enrollment ID: I20200528000236 |
| Provider Name | Shiloh Tackett |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1336567643 PECOS PAC ID: 4688899677 Enrollment ID: I20200629000275 |
| Provider Name | Sarah Crowley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841819521 PECOS PAC ID: 7810310232 Enrollment ID: I20200701003133 |
| Provider Name | Robin Johnson Cook |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487068383 PECOS PAC ID: 8527375427 Enrollment ID: I20200716000074 |
| Provider Name | Sara Witek |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1265068894 PECOS PAC ID: 7012331564 Enrollment ID: I20200716004025 |
| Provider Name | Jacob Szafranski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407383615 PECOS PAC ID: 5698191013 Enrollment ID: I20200817001462 |
| Provider Name | Kristen Duman Scholten |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1689036733 PECOS PAC ID: 0547556656 Enrollment ID: I20200819002315 |
| Provider Name | Alyssa M Vermeulen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700291515 PECOS PAC ID: 1355566167 Enrollment ID: I20200826000782 |
| Provider Name | Sarah Mccalley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023627171 PECOS PAC ID: 4981021367 Enrollment ID: I20200831001932 |
| Provider Name | Brian G Gilbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902415193 PECOS PAC ID: 1951728054 Enrollment ID: I20200903002797 |
| Provider Name | Jami Grosberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407474364 PECOS PAC ID: 5890107064 Enrollment ID: I20201211000355 |
| Provider Name | Ellen Talbott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386231223 PECOS PAC ID: 3173936648 Enrollment ID: I20201231000706 |
| Provider Name | William E L Reichardt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194174789 PECOS PAC ID: 7517254378 Enrollment ID: I20210122001784 |
| Provider Name | Madison Mary Forsyth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780289199 PECOS PAC ID: 9739593260 Enrollment ID: I20210125002180 |
| Provider Name | Pamela A Dusseau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295335305 PECOS PAC ID: 1759796584 Enrollment ID: I20210209000548 |
| Provider Name | Edward Chen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992110316 PECOS PAC ID: 0143640748 Enrollment ID: I20210326001618 |
| Provider Name | Callie Paige Leaman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790377836 PECOS PAC ID: 7214344662 Enrollment ID: I20210331000843 |
| Provider Name | Carly Batcha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952996159 PECOS PAC ID: 5890103642 Enrollment ID: I20210416000814 |
| Provider Name | Jennifer Symons |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518404045 PECOS PAC ID: 4688082860 Enrollment ID: I20210428001725 |
| Provider Name | Jessica Maria Zionskowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841835196 PECOS PAC ID: 5395154496 Enrollment ID: I20210430001605 |
| Provider Name | Sina Jame |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1366885824 PECOS PAC ID: 5092007955 Enrollment ID: I20210602000246 |
| Provider Name | Jack Zuckerman |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1508093428 PECOS PAC ID: 3476773938 Enrollment ID: I20210610001538 |
| Provider Name | Michael Vanwagner |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1639551559 PECOS PAC ID: 7810200797 Enrollment ID: I20210615001312 |
| Provider Name | Tyler Humphrey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1467980102 PECOS PAC ID: 9234554924 Enrollment ID: I20210630003521 |
| Provider Name | Charles A Asbury |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1114378692 PECOS PAC ID: 2769774728 Enrollment ID: I20210713003374 |
| Provider Name | Ryan Scot Burke |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1639566094 PECOS PAC ID: 6800299447 Enrollment ID: I20210720003606 |
| Provider Name | Zachary Wilseck |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1023499878 PECOS PAC ID: 4587978770 Enrollment ID: I20210802001017 |
| Provider Name | Prasanthi Yelavarthy |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1942620380 PECOS PAC ID: 2163716523 Enrollment ID: I20210812001161 |
| Provider Name | Morgan Buda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689161663 PECOS PAC ID: 9234494485 Enrollment ID: I20210830000970 |
| Provider Name | Megan Michelle Owens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841966215 PECOS PAC ID: 9234534207 Enrollment ID: I20210830001335 |
| Provider Name | Darla Balas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912357096 PECOS PAC ID: 6608160080 Enrollment ID: I20210929002792 |
| Provider Name | Whitney Ashton Mervau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134720899 PECOS PAC ID: 6002207495 Enrollment ID: I20211218000039 |
| Provider Name | Alicia Becker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760076715 PECOS PAC ID: 6709277148 Enrollment ID: I20211220001758 |
| Provider Name | Alexandra I Tepkasetkul |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770013203 PECOS PAC ID: 4587934096 Enrollment ID: I20211231000025 |
| Provider Name | Natalie E Cook |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164914214 PECOS PAC ID: 0749672111 Enrollment ID: I20220114000571 |
| Provider Name | Noori Al-waili |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1215215579 PECOS PAC ID: 5597909093 Enrollment ID: I20220126000632 |
| Provider Name | Jamie Michele Warnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730851536 PECOS PAC ID: 8123411006 Enrollment ID: I20220217001624 |
| Provider Name | George Contos |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1376075770 PECOS PAC ID: 5698043974 Enrollment ID: I20220218001780 |
| Provider Name | Sahar Awad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174969299 PECOS PAC ID: 8224261490 Enrollment ID: I20220314001003 |
| Provider Name | Katrina Lawrence-wolff |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1013283845 PECOS PAC ID: 3072759166 Enrollment ID: I20220426001464 |
| Provider Name | Emily Margaret Bicknell |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1336892694 PECOS PAC ID: 5698162105 Enrollment ID: I20220503000282 |
| Provider Name | Diana Elizabeth Bischer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629693791 PECOS PAC ID: 1456738376 Enrollment ID: I20220516001608 |
| Provider Name | Michael Opperman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427554310 PECOS PAC ID: 9234484569 Enrollment ID: I20220526001060 |
| Provider Name | Amy N Keck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851710842 PECOS PAC ID: 9931587599 Enrollment ID: I20220609002696 |
| Provider Name | Karla Giese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780676262 PECOS PAC ID: 9537211859 Enrollment ID: I20220628003632 |
| Provider Name | Brandon Wojcik |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1851653661 PECOS PAC ID: 9335392521 Enrollment ID: I20220728002100 |
| Provider Name | Carter B Anderson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134625585 PECOS PAC ID: 5395094858 Enrollment ID: I20220803001626 |
| Provider Name | Stephanie Grace Abinoja Raymundo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003294455 PECOS PAC ID: 1254603566 Enrollment ID: I20220805000239 |
| Provider Name | Shelly J Wood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578796272 PECOS PAC ID: 6002298130 Enrollment ID: I20220805000278 |
| Provider Name | Jennifer Armstrong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447866330 PECOS PAC ID: 1759764533 Enrollment ID: I20220811000159 |
| Provider Name | David Leonard Ortiz |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1619312246 PECOS PAC ID: 0345545273 Enrollment ID: I20220818000800 |
| Provider Name | Barent Bradt |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1629605654 PECOS PAC ID: 1254756034 Enrollment ID: I20220915001112 |
| Provider Name | Shawna Marie Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205556636 PECOS PAC ID: 1254717259 Enrollment ID: I20220928002222 |
| Provider Name | Makenzie Tremp |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891284360 PECOS PAC ID: 6507233053 Enrollment ID: I20221114000563 |
| Provider Name | Christopher J Genther |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427792175 PECOS PAC ID: 5395113484 Enrollment ID: I20221121002475 |
| Provider Name | Chelsy Boelkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437868924 PECOS PAC ID: 8628448305 Enrollment ID: I20221222000624 |
| Provider Name | Kevin Harris |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366804593 PECOS PAC ID: 3072805241 Enrollment ID: I20221223000768 |
| Provider Name | Jill Marie Fowler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942881818 PECOS PAC ID: 3971974684 Enrollment ID: I20230117001150 |
| Provider Name | Edward R Hagen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1811359268 PECOS PAC ID: 2860787009 Enrollment ID: I20230201002051 |
| Provider Name | William A Austin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1275983108 PECOS PAC ID: 7911290788 Enrollment ID: I20230209002068 |
| Provider Name | Nancy Slabosz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770706889 PECOS PAC ID: 3476851056 Enrollment ID: I20230225000345 |
| Provider Name | John Brunner |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1245236793 PECOS PAC ID: 7113960014 Enrollment ID: I20230307000870 |
| Provider Name | Chantal Hopper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194422469 PECOS PAC ID: 0446615629 Enrollment ID: I20230421000699 |
| Provider Name | Ty Michael Curtis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467798777 PECOS PAC ID: 6608231162 Enrollment ID: I20230505001053 |
| Provider Name | Philip Michael Mccarthy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1720573025 PECOS PAC ID: 1153665336 Enrollment ID: I20230602000564 |
| Provider Name | Cody Alan Overmyer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477059160 PECOS PAC ID: 9739438169 Enrollment ID: I20230621000433 |
| Provider Name | Miriam Janelle Rienstra-bareman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134748650 PECOS PAC ID: 6800254970 Enrollment ID: I20230621003286 |
| Provider Name | Mari Sams |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1952887804 PECOS PAC ID: 2860851961 Enrollment ID: I20230707001763 |
| Provider Name | David Rosenbaum |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1174867980 PECOS PAC ID: 4183045248 Enrollment ID: I20230707003212 |
| Provider Name | Jenna Racine |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225449291 PECOS PAC ID: 3971823659 Enrollment ID: I20230721002101 |
| Provider Name | Elizabeth Clayton Wheeler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326383639 PECOS PAC ID: 0143682203 Enrollment ID: I20230822001248 |
| Provider Name | Kurt Ryan Bjorkman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609254499 PECOS PAC ID: 7719299940 Enrollment ID: I20230828000986 |
| Provider Name | Donald Scholten |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1386176964 PECOS PAC ID: 2062782964 Enrollment ID: I20230829001145 |
| Provider Name | Tammy Szostakowski Lafaive |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1619753464 PECOS PAC ID: 3375907918 Enrollment ID: I20230914002220 |
| Provider Name | Bianca Avolio |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1154002780 PECOS PAC ID: 3870957467 Enrollment ID: I20230915000253 |
| Provider Name | Jordan Nester |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1689106270 PECOS PAC ID: 4688943897 Enrollment ID: I20230921003273 |
| Provider Name | Taylor Lee Dawson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1396126595 PECOS PAC ID: 9133424781 Enrollment ID: I20230922000645 |
| Provider Name | Brittney Harding |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174086268 PECOS PAC ID: 1456742980 Enrollment ID: I20230929003128 |
| Provider Name | Ajleeta Sangtani Nestani |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1306200936 PECOS PAC ID: 4587956339 Enrollment ID: I20231019001261 |
| Provider Name | Ryan Taylor Greene |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649723511 PECOS PAC ID: 8123358157 Enrollment ID: I20231027003375 |
| Provider Name | Deanne R Briggs |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023227568 PECOS PAC ID: 8628426939 Enrollment ID: I20231128000730 |
| Provider Name | Lesley A Eddington |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689829954 PECOS PAC ID: 2860840006 Enrollment ID: I20231128002170 |
| Provider Name | Caitlin Buren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215637814 PECOS PAC ID: 2567811136 Enrollment ID: I20231207001946 |
| Provider Name | Ammar Kheder |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770925976 PECOS PAC ID: 3779711791 Enrollment ID: I20231215001463 |
| Provider Name | Joseph Howells |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1861837304 PECOS PAC ID: 1052533684 Enrollment ID: I20231215003126 |
| Provider Name | Melinda Eng |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1831765775 PECOS PAC ID: 9335599166 Enrollment ID: I20231220001341 |
| Provider Name | Lora L Minidis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811245558 PECOS PAC ID: 1254781677 Enrollment ID: I20231228000434 |
| Provider Name | Michael Mcdonald |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1457892879 PECOS PAC ID: 5395014146 Enrollment ID: I20231228000461 |
| Provider Name | Robert Nicholas Tiballi |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1194757427 PECOS PAC ID: 6406839737 Enrollment ID: I20231229001617 |
| Provider Name | Joanne Mary Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720711765 PECOS PAC ID: 4981054095 Enrollment ID: I20240102000426 |
| Provider Name | Chad Thomas Bousamra |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164694030 PECOS PAC ID: 0446601280 Enrollment ID: I20240105003229 |
| Provider Name | Shawn Ruiz |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1437927423 PECOS PAC ID: 0143673855 Enrollment ID: I20240130000960 |
| Provider Name | Michael D Newman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336702570 PECOS PAC ID: 0042661027 Enrollment ID: I20240202003649 |
| Provider Name | Sarah L Mills |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1255868972 PECOS PAC ID: 6103196209 Enrollment ID: I20240213000273 |
| Provider Name | Dallas Rae Foley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548021280 PECOS PAC ID: 4981041878 Enrollment ID: I20240327003296 |
| Provider Name | Steven M Schwimmer |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1841253143 PECOS PAC ID: 3173582251 Enrollment ID: I20240403000369 |
| Provider Name | Gruschen Veldtman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437592359 PECOS PAC ID: 5294965836 Enrollment ID: I20240528000606 |
| Provider Name | Jennifer Cate |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1932636313 PECOS PAC ID: 1254600315 Enrollment ID: I20240607000536 |
| Provider Name | Christina M Ingham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427599190 PECOS PAC ID: 8224390083 Enrollment ID: I20240618001516 |
| Provider Name | Edward Carey |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1679070544 PECOS PAC ID: 1355695032 Enrollment ID: I20240620001678 |
| Provider Name | Desiree Lynn Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942916507 PECOS PAC ID: 3072056514 Enrollment ID: I20240625001485 |
| Provider Name | Aeman Hana |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720583099 PECOS PAC ID: 8325382583 Enrollment ID: I20240626000472 |
| Provider Name | Presleigh Yovich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497510952 PECOS PAC ID: 7911441357 Enrollment ID: I20240626004391 |
| Provider Name | Neil V Klinger |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1780118976 PECOS PAC ID: 2062780521 Enrollment ID: I20240627000353 |
| Provider Name | Miriam Brown |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689230476 PECOS PAC ID: 6204162787 Enrollment ID: I20240702000759 |
| Provider Name | Ruben Barroso |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922673243 PECOS PAC ID: 6305212655 Enrollment ID: I20240709000237 |
| Provider Name | Anthony Mcclafferty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871021758 PECOS PAC ID: 5890112346 Enrollment ID: I20240718004219 |
| Provider Name | Mary L Harwood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073285078 PECOS PAC ID: 3173069648 Enrollment ID: I20240719002298 |
| Provider Name | Cory Messingschlager |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245723527 PECOS PAC ID: 1951658087 Enrollment ID: I20240724000257 |
| Provider Name | Ramiro Gabriel Castro Apolo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881189645 PECOS PAC ID: 6204372485 Enrollment ID: I20240724001054 |
| Provider Name | Timothy Sorg |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1467441873 PECOS PAC ID: 0547233488 Enrollment ID: I20240806000469 |
| Provider Name | Shannon Dodds |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548766371 PECOS PAC ID: 8527506013 Enrollment ID: I20240815000469 |
| Provider Name | Joseph Frazee |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1942820840 PECOS PAC ID: 2961823752 Enrollment ID: I20240905003534 |
| Provider Name | Kirsten Rosemarie Wilhelm |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1093137184 PECOS PAC ID: 6608226766 Enrollment ID: I20240911003426 |
| Provider Name | Brittany Armstrong |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1598205932 PECOS PAC ID: 0143590133 Enrollment ID: I20240912001498 |
| Provider Name | Matthew Schuch |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1457857138 PECOS PAC ID: 8224384185 Enrollment ID: I20241001001600 |
| Provider Name | Grace Breuer |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1699331199 PECOS PAC ID: 8325374986 Enrollment ID: I20241212001772 |
| Provider Name | Nicholas Zendler |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1275897068 PECOS PAC ID: 8325348238 Enrollment ID: I20241230002118 |
| Provider Name | Amanda Yanska |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316546450 PECOS PAC ID: 4880008325 Enrollment ID: I20250103001439 |
| Provider Name | Ryan Urbonas |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1710244280 PECOS PAC ID: 2062639040 Enrollment ID: I20250116001277 |
| Provider Name | Leeda Bashardost |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164142253 PECOS PAC ID: 0042730962 Enrollment ID: I20250222000228 |
County Health Support Services Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 320 Washington St, Traverse City, MI 49684 Phone: 231-922-4532 | |
Northwest Michigan Health Services, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1776 3 Mile Rd N Rm 522, Traverse City, MI 49696 Phone: 231-642-9295 | |
Best Medical Services Plc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 814 S Garfield Ave Ste C, Traverse City, MI 49686 Phone: 231-922-8722 Fax: 231-486-6042 | |
Partners In Health Of Traverse City Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3074 N Us 31 S, Traverse City, MI 49684 Phone: 231-935-0535 Fax: 231-935-0454 | |
Indigo Hospital Medicine - Traverse City, Plc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1105 Sixth St, Traverse City, MI 49684 Phone: 231-346-6807 Fax: 231-346-6052 | |
Bayside Doc's Urgent Care Office Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 Munson Ave, Traverse City, MI 49686 Phone: 231-933-9150 Fax: 231-933-1553 |