| Gastroenterology Associates Pa | |
|
415 N Center St Suite 300 Hickory NC 28601-5036 | |
| (828) 328-3300 | |
| (828) 328-3288 |
| Full Name | Gastroenterology Associates Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 415 N Center St, Hickory, North Carolina |
| Authorized Official Name and Position | Revonda B Rand (PRACTICE MANAGER) |
| Authorized Official Contact | 8283283300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastroenterology Associates Pa 415 N Center St Suite 300 Hickory NC 28601-5036 Ph: (828) 328-3300 | Gastroenterology Associates Pa 415 N Center St Suite 300 Hickory NC 28601-5036 Ph: (828) 328-3300 |
| NPI Number | 1750346748 |
|---|---|
| Provider Enumeration Date | 04/20/2006 |
| Last Update Date | 07/16/2010 |
| Medicare PECOS PAC ID | 0345342788 |
|---|---|
| Medicare Enrollment ID | O20080620000083 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750346748 | NPI | - | NPPES |
| 890211T | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Pouneh Mofrad Nikrooz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992738983 PECOS PAC ID: 5193798866 Enrollment ID: I20050827000063 |
| Provider Name | Gaa Richardson |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1003011578 PECOS PAC ID: 1355413253 Enrollment ID: I20080710000078 |
| Provider Name | Caroll D Koscheski |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1316901515 PECOS PAC ID: 0143322586 Enrollment ID: I20100805000987 |
| Provider Name | John Harvey Meier |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1043274244 PECOS PAC ID: 2062514409 Enrollment ID: I20100806000709 |
| Provider Name | Simon John Allport |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1730166554 PECOS PAC ID: 7416059852 Enrollment ID: I20100819000512 |
| Provider Name | Diane T Scaife |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598945834 PECOS PAC ID: 8123285038 Enrollment ID: I20160322000710 |
| Provider Name | Genevieve Angelina Morales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285123109 PECOS PAC ID: 4981954484 Enrollment ID: I20180904002569 |
| Provider Name | Kristen A Suchniak-mussari |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1902148331 PECOS PAC ID: 5799073102 Enrollment ID: I20190628002675 |
| Provider Name | Michelle Lumpkin Sain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376174078 PECOS PAC ID: 4385064427 Enrollment ID: I20201012001575 |
| Provider Name | Disha N Shah |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1063822732 PECOS PAC ID: 8921366006 Enrollment ID: I20210809000174 |
| Provider Name | Bradley J Zins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497776777 PECOS PAC ID: 0042217945 Enrollment ID: I20220302000024 |
| Provider Name | Behnam Laderian |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1518494236 PECOS PAC ID: 9335418037 Enrollment ID: I20231006002979 |
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