Fayette Physician Network Inc | |
250 Maple St Friendsville MD 21531-2122 | |
(301) 746-4160 | |
(301) 746-4162 |
Full Name | Fayette Physician Network Inc |
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Speciality | Family Medicine |
Location | 250 Maple St, Friendsville, Maryland |
Authorized Official Name and Position | David Frederick Hess (PRESIDENT/CEO) |
Authorized Official Contact | 7244305000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Fayette Physician Network Inc Po Box 796 Morgantown WV 26507-0796 Ph: (800) 541-4009 | Fayette Physician Network Inc 250 Maple St Friendsville MD 21531-2122 Ph: (301) 746-4160 |
NPI Number | 1437823044 |
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Provider Enumeration Date | 08/06/2021 |
Last Update Date | 08/06/2021 |
Medicare PECOS PAC ID | 3375865819 |
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Medicare Enrollment ID | O20220822000080 |
Identifier | Type | State | Issuer |
---|---|---|---|
1437823044 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Eric Roger Balzano |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1992772651 PECOS PAC ID: 6103886015 Enrollment ID: I20041110000620 |
Provider Name | Mark Benson |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1023085875 PECOS PAC ID: 6800856808 Enrollment ID: I20041110000652 |
Provider Name | John Leonard De Filippo |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1154398907 PECOS PAC ID: 9133189210 Enrollment ID: I20041110000690 |
Provider Name | Vincent J Caruso |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1104893973 PECOS PAC ID: 6406816586 Enrollment ID: I20041110000718 |
Provider Name | Gary Loh |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1760459218 PECOS PAC ID: 7214997394 Enrollment ID: I20041110000804 |
Provider Name | Kevin M Clarke |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1487664835 PECOS PAC ID: 0648217638 Enrollment ID: I20050412000157 |
Provider Name | Carter A Kenamond |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1285779686 PECOS PAC ID: 6901904903 Enrollment ID: I20070614000049 |
Provider Name | Aimee Seningen |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1144424961 PECOS PAC ID: 0244328904 Enrollment ID: I20071113000559 |
Provider Name | Christopher C Nicely |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1548438435 PECOS PAC ID: 2668631672 Enrollment ID: I20120312000339 |
Provider Name | Kara L Leslie |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1821257239 PECOS PAC ID: 4284861998 Enrollment ID: I20131227001861 |
Provider Name | Sanjeev Katyal |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1750385019 PECOS PAC ID: 8729081450 Enrollment ID: I20171010000027 |
Provider Name | Brian Schambach |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1043607013 PECOS PAC ID: 3173839602 Enrollment ID: I20210519002027 |
Provider Name | Maximilian Schellinger |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1780079848 PECOS PAC ID: 4082911094 Enrollment ID: I20210921002076 |
Provider Name | Jacob William Sechrist |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1285920447 PECOS PAC ID: 3274827886 Enrollment ID: I20211110002435 |
Provider Name | Brian Keith Jones |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518408756 PECOS PAC ID: 4486058955 Enrollment ID: I20220511002068 |
Provider Name | Ahsan Ullah Khan |
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Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1437672391 PECOS PAC ID: 9234473992 Enrollment ID: I20220802000035 |
Provider Name | Anna Maria Suray |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1407819360 PECOS PAC ID: 6800984568 Enrollment ID: I20221026000896 |
Provider Name | Sonali Mehta |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1225148505 PECOS PAC ID: 6507233111 Enrollment ID: I20221110000219 |
Provider Name | Alyssa Barnette |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669024709 PECOS PAC ID: 1658744008 Enrollment ID: I20230306000865 |
Provider Name | Jessica Oliverio |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598169500 PECOS PAC ID: 2769857788 Enrollment ID: I20230405000696 |
Provider Name | Andrew Wilmot |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1154527745 PECOS PAC ID: 2961627419 Enrollment ID: I20230911000736 |
Provider Name | Aaron Heaberlin |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1285169581 PECOS PAC ID: 1759650344 Enrollment ID: I20231101000690 |
Provider Name | Analissa Marie White |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053003061 PECOS PAC ID: 3476913351 Enrollment ID: I20231211002275 |
Provider Name | Dhairya Lakhani |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1669969515 PECOS PAC ID: 7416206099 Enrollment ID: I20240515000652 |
Provider Name | Edward Harris Estrin |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1831160142 PECOS PAC ID: 0547258816 Enrollment ID: I20250402003233 |
Provider Name | Nathan Johnson |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1285824623 PECOS PAC ID: 2264504976 Enrollment ID: I20250414002501 |
Provider Name | Nicholas Naro |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1740679604 PECOS PAC ID: 6305131434 Enrollment ID: I20250414002570 |
Provider Name | Ivy Nguyen |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1831695584 PECOS PAC ID: 1759617327 Enrollment ID: I20250414003107 |
Provider Name | Joseph Mollura |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1093024754 PECOS PAC ID: 3072870260 Enrollment ID: I20250415000675 |
Provider Name | Katelyn Ziggas |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1861835332 PECOS PAC ID: 3678829892 Enrollment ID: I20250415001995 |