| Medical Practices Of Antietam, Llc | |
|
11110 Medical Campus Road Suite 229 Hagerstown MD 21742 | |
| (301) 665-4531 | |
| (301) 790-9103 |
| Full Name | Medical Practices Of Antietam, Llc |
|---|---|
| Speciality | General Practice |
| Location | 11110 Medical Campus Road, Hagerstown, Maryland |
| Authorized Official Name and Position | Joshua Repac (CFO) |
| Authorized Official Contact | 3017909351 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Practices Of Antietam, Llc 11110 Medical Campus Road Suite 229 Hagerstown MD 21742 Ph: (301) 665-4531 | Medical Practices Of Antietam, Llc 11110 Medical Campus Road Suite 229 Hagerstown MD 21742 Ph: (301) 665-4531 |
| NPI Number | 1558430843 |
|---|---|
| Provider Enumeration Date | 11/08/2006 |
| Last Update Date | 10/26/2022 |
| Medicare PECOS PAC ID | 2567353865 |
|---|---|
| Medicare Enrollment ID | O20040324001019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558430843 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Adrian E Park |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1376567099 PECOS PAC ID: 0840181533 Enrollment ID: I20040323000186 |
| Provider Name | Samuel Peter Eng |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134199557 PECOS PAC ID: 0244122703 Enrollment ID: I20040329000644 |
| Provider Name | Christine A Diamond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780627893 PECOS PAC ID: 5395735591 Enrollment ID: I20040518000285 |
| Provider Name | Dean Notabartolo |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1447231071 PECOS PAC ID: 0244215366 Enrollment ID: I20040622001700 |
| Provider Name | Joseph N Holobinko |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1821058603 PECOS PAC ID: 7214914985 Enrollment ID: I20040630000924 |
| Provider Name | Mahesh Krishnamoorthy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962465666 PECOS PAC ID: 1951380468 Enrollment ID: I20040719000221 |
| Provider Name | Samuel C Bieligk |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1982618112 PECOS PAC ID: 2567423999 Enrollment ID: I20041020000173 |
| Provider Name | Kate M Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861431462 PECOS PAC ID: 4587627732 Enrollment ID: I20041109000092 |
| Provider Name | Frank Joseph Collins |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1780783621 PECOS PAC ID: 5597702274 Enrollment ID: I20050420001161 |
| Provider Name | Ramakrishna R Kosuri |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1588624498 PECOS PAC ID: 1456335769 Enrollment ID: I20060203000323 |
| Provider Name | Katey L Purgason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063442796 PECOS PAC ID: 3274535976 Enrollment ID: I20070209000033 |
| Provider Name | Adjoavi F Andele |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1972530202 PECOS PAC ID: 9931101466 Enrollment ID: I20070212000607 |
| Provider Name | Matthew H Gibson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679684310 PECOS PAC ID: 5991793093 Enrollment ID: I20070216000078 |
| Provider Name | Diane Sandy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487735031 PECOS PAC ID: 0143327080 Enrollment ID: I20070529000544 |
| Provider Name | Girish T Reddy |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1891913240 PECOS PAC ID: 9234222183 Enrollment ID: I20070907000694 |
| Provider Name | Jennifer E Kuhn |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1154443893 PECOS PAC ID: 2264526029 Enrollment ID: I20070924000680 |
| Provider Name | Craig L Louisy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457553364 PECOS PAC ID: 0648366401 Enrollment ID: I20071010000296 |
| Provider Name | Pajman A Danai |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1437180528 PECOS PAC ID: 3577576883 Enrollment ID: I20071105000369 |
| Provider Name | Chintamaneni P Choudari |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1538148283 PECOS PAC ID: 8426130378 Enrollment ID: I20080130000652 |
| Provider Name | Mudusar I Raza |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1467562371 PECOS PAC ID: 8527163997 Enrollment ID: I20080213000356 |
| Provider Name | Tania R Crussiah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497962450 PECOS PAC ID: 7719061001 Enrollment ID: I20080226000198 |
| Provider Name | Kathy Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508841438 PECOS PAC ID: 6608950738 Enrollment ID: I20080227000414 |
| Provider Name | Stephan B Williams |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1528131687 PECOS PAC ID: 8628013109 Enrollment ID: I20080415000728 |
| Provider Name | Solveig K Locke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982618492 PECOS PAC ID: 8628146321 Enrollment ID: I20081008000366 |
| Provider Name | Cynthia Carter Malcolm |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1437287059 PECOS PAC ID: 6406924067 Enrollment ID: I20081009000106 |
| Provider Name | Nicole Hensley |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1992757462 PECOS PAC ID: 6800964412 Enrollment ID: I20081009000558 |
| Provider Name | Christopher S Vaccari |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1912092115 PECOS PAC ID: 1153422969 Enrollment ID: I20081013000064 |
| Provider Name | William C Hamilton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1346207248 PECOS PAC ID: 9537237920 Enrollment ID: I20081013000405 |
| Provider Name | Anne Rowland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689840571 PECOS PAC ID: 0941368146 Enrollment ID: I20081016000269 |
| Provider Name | Bernadette R Greco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215918362 PECOS PAC ID: 0345308136 Enrollment ID: I20081023000168 |
| Provider Name | Kevin C Hackett |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1568419901 PECOS PAC ID: 5294893376 Enrollment ID: I20081023000473 |
| Provider Name | Patrick J Dennis |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1932140530 PECOS PAC ID: 4385702463 Enrollment ID: I20081023000485 |
| Provider Name | Donna E Lofton |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1669423133 PECOS PAC ID: 5294894721 Enrollment ID: I20081112000477 |
| Provider Name | Stephen Metzner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851396089 PECOS PAC ID: 9931115813 Enrollment ID: I20081223000201 |
| Provider Name | Kristy C Hose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417005265 PECOS PAC ID: 9032272109 Enrollment ID: I20090115000416 |
| Provider Name | Kelli A Strauss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033114244 PECOS PAC ID: 2668488545 Enrollment ID: I20090122000612 |
| Provider Name | Vincent Agatino Cantone |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851356968 PECOS PAC ID: 9032258801 Enrollment ID: I20091208000403 |
| Provider Name | William B Kerns |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326003666 PECOS PAC ID: 0941340756 Enrollment ID: I20091229000315 |
| Provider Name | Brian K. Bonham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366407975 PECOS PAC ID: 1153461975 Enrollment ID: I20091229000385 |
| Provider Name | Zubair H Faridi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1740283241 PECOS PAC ID: 4587655188 Enrollment ID: I20100310000127 |
| Provider Name | Jeffrey D. Jones |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1215930714 PECOS PAC ID: 2062403652 Enrollment ID: I20100310000158 |
| Provider Name | Michael William Costello |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740250125 PECOS PAC ID: 4082740931 Enrollment ID: I20100330000608 |
| Provider Name | William E Royster |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598798621 PECOS PAC ID: 7113057175 Enrollment ID: I20100617000639 |
| Provider Name | Matthew G Beckwith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235162280 PECOS PAC ID: 4183754146 Enrollment ID: I20100617000681 |
| Provider Name | Nelson L Ferreira |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1679563746 PECOS PAC ID: 9234262833 Enrollment ID: I20100803000975 |
| Provider Name | Michael J Mccormack |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1821018821 PECOS PAC ID: 0042306482 Enrollment ID: I20100831000697 |
| Provider Name | Jerry L Correces |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770535320 PECOS PAC ID: 9931162187 Enrollment ID: I20101004000360 |
| Provider Name | Michael J Odonoghue |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1285711192 PECOS PAC ID: 8325230725 Enrollment ID: I20101004000928 |
| Provider Name | Stephen M Sachs |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356344592 PECOS PAC ID: 0244296903 Enrollment ID: I20101005000669 |
| Provider Name | Susanna Goheen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548295587 PECOS PAC ID: 7911939178 Enrollment ID: I20101012000966 |
| Provider Name | Mohammed Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497751853 PECOS PAC ID: 4284604539 Enrollment ID: I20101015000425 |
| Provider Name | Kevin Hurtt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083717185 PECOS PAC ID: 0446337786 Enrollment ID: I20101022000656 |
| Provider Name | Jessica Close |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1699978866 PECOS PAC ID: 7113115148 Enrollment ID: I20101217000229 |
| Provider Name | Jay B Greenberg |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1154322238 PECOS PAC ID: 6507054822 Enrollment ID: I20110105001140 |
| Provider Name | Eric J Kraut |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255439626 PECOS PAC ID: 3971401100 Enrollment ID: I20110610000309 |
| Provider Name | Dang Nguyen |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1255518403 PECOS PAC ID: 6305011180 Enrollment ID: I20111206000398 |
| Provider Name | David Rossi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720283807 PECOS PAC ID: 4587752191 Enrollment ID: I20111215000413 |
| Provider Name | Shaheen Iqbal |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1194709394 PECOS PAC ID: 1658272919 Enrollment ID: I20120125000207 |
| Provider Name | Kalim Ahmed |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1194709204 PECOS PAC ID: 0345141610 Enrollment ID: I20120125000390 |
| Provider Name | Rachel H Tuer |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1871758409 PECOS PAC ID: 1850438946 Enrollment ID: I20120229000009 |
| Provider Name | Gary M Sherman |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1669432027 PECOS PAC ID: 7416931720 Enrollment ID: I20120301000116 |
| Provider Name | Scott P Worrell |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1598725442 PECOS PAC ID: 2860476173 Enrollment ID: I20120507000097 |
| Provider Name | Salvatore Dimercurio |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1578505798 PECOS PAC ID: 1456340272 Enrollment ID: I20120514000300 |
| Provider Name | Paul M Mauriello |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1245246958 PECOS PAC ID: 5698719680 Enrollment ID: I20120518000477 |
| Provider Name | Mohammed Bilgrami |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1457678898 PECOS PAC ID: 0840454690 Enrollment ID: I20120615000332 |
| Provider Name | Samuel J. Rao |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447361050 PECOS PAC ID: 6204098049 Enrollment ID: I20120806000400 |
| Provider Name | Susan K Lyons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710252150 PECOS PAC ID: 1850547514 Enrollment ID: I20120813000088 |
| Provider Name | Daniel J Warner |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1457562480 PECOS PAC ID: 8123292018 Enrollment ID: I20120920000483 |
| Provider Name | Elizabeth A Wolfinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962680850 PECOS PAC ID: 2264504364 Enrollment ID: I20130117000260 |
| Provider Name | Liza Dawn Hiles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518296615 PECOS PAC ID: 0244476794 Enrollment ID: I20130429000491 |
| Provider Name | Hugo Bonatti |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1861609869 PECOS PAC ID: 6002976800 Enrollment ID: I20130820000436 |
| Provider Name | Aboubakr Khairat |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1720246358 PECOS PAC ID: 3678707700 Enrollment ID: I20131003000410 |
| Provider Name | Ann-marie Nicole Hugh |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104843069 PECOS PAC ID: 2668447160 Enrollment ID: I20131008000786 |
| Provider Name | Thulani Stewart |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1710927256 PECOS PAC ID: 9133199458 Enrollment ID: I20131206000427 |
| Provider Name | Jasmine O Pega |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083017446 PECOS PAC ID: 0547582066 Enrollment ID: I20141211000084 |
| Provider Name | Dipti Mohanlal Mistry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407173610 PECOS PAC ID: 2163745399 Enrollment ID: I20141219001244 |
| Provider Name | Pamela Mcmullan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093117004 PECOS PAC ID: 2062736739 Enrollment ID: I20150129000708 |
| Provider Name | Fady E Tohme |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275502981 PECOS PAC ID: 3476529132 Enrollment ID: I20150414002343 |
| Provider Name | Obafemi O Okuwobi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427058361 PECOS PAC ID: 3678585478 Enrollment ID: I20150619001134 |
| Provider Name | Victoria Marie Saah Giffi |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1447419627 PECOS PAC ID: 3870805930 Enrollment ID: I20150701001786 |
| Provider Name | Shelley Ann Castle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073646931 PECOS PAC ID: 8921310996 Enrollment ID: I20150706000112 |
| Provider Name | Nikolai Anton Sopko |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013283472 PECOS PAC ID: 1355599747 Enrollment ID: I20150812008018 |
| Provider Name | Kiranpreet Kaur Khosa |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1861650384 PECOS PAC ID: 9133390255 Enrollment ID: I20150902000497 |
| Provider Name | Richard C Bryson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1417272261 PECOS PAC ID: 2769791383 Enrollment ID: I20151022000940 |
| Provider Name | Gwendolyn Orfan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538538871 PECOS PAC ID: 5193035350 Enrollment ID: I20151030001826 |
| Provider Name | Elizabeth Ann Dowdell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851751341 PECOS PAC ID: 7214101385 Enrollment ID: I20160420000076 |
| Provider Name | Leon Weaver |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255323119 PECOS PAC ID: 4385942598 Enrollment ID: I20160420002079 |
| Provider Name | Kristina Athey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356344139 PECOS PAC ID: 1951600899 Enrollment ID: I20160428000236 |
| Provider Name | Anne Rao |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356504245 PECOS PAC ID: 2769772904 Enrollment ID: I20160601000270 |
| Provider Name | Atchuthanand Budi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1104881200 PECOS PAC ID: 3072803006 Enrollment ID: I20160603001420 |
| Provider Name | Hemant Chatrath |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1639306012 PECOS PAC ID: 7315090255 Enrollment ID: I20160804000307 |
| Provider Name | Vamshidhar Vootla |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1144485467 PECOS PAC ID: 3678720034 Enrollment ID: I20160822000057 |
| Provider Name | Tara Mcrae |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871046045 PECOS PAC ID: 0143517169 Enrollment ID: I20160920000049 |
| Provider Name | Stacey N Gibson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154876423 PECOS PAC ID: 6507154945 Enrollment ID: I20161018000827 |
| Provider Name | Pratikkumar Sheth |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1962711069 PECOS PAC ID: 2668699513 Enrollment ID: I20161214002042 |
| Provider Name | Kyle Remick |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1659315356 PECOS PAC ID: 5496904914 Enrollment ID: I20161220002038 |
| Provider Name | Keir Thelander |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1578006508 PECOS PAC ID: 9133105836 Enrollment ID: I20170403001048 |
| Provider Name | Arpitha A Polagani |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1467796854 PECOS PAC ID: 3870746886 Enrollment ID: I20170418000160 |
| Provider Name | Victor Okanimba Anyangwe |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1295020220 PECOS PAC ID: 9638448228 Enrollment ID: I20170713002486 |
| Provider Name | Basile M Njei |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1336435965 PECOS PAC ID: 1456662030 Enrollment ID: I20170718000095 |
| Provider Name | Adam Scott Weltz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1710286471 PECOS PAC ID: 4284932583 Enrollment ID: I20170725001409 |
| Provider Name | Jamie C Worsley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417375692 PECOS PAC ID: 0547534455 Enrollment ID: I20170915001491 |
| Provider Name | Merih D O Donoghue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053836577 PECOS PAC ID: 5092081844 Enrollment ID: I20171023000644 |
| Provider Name | Jennifer Renee Burnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396263778 PECOS PAC ID: 6608132360 Enrollment ID: I20171113002532 |
| Provider Name | Brandy Locke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235652678 PECOS PAC ID: 8224396668 Enrollment ID: I20171213000512 |
| Provider Name | Mohammad K Jamal |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1790766749 PECOS PAC ID: 8224061635 Enrollment ID: I20171213001289 |
| Provider Name | Kendra S Magner |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1063921856 PECOS PAC ID: 5092073734 Enrollment ID: I20171229000789 |
| Provider Name | Denise Ann Ringley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861922536 PECOS PAC ID: 3274892666 Enrollment ID: I20180110000632 |
| Provider Name | Carlina D Burcker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962917906 PECOS PAC ID: 8527328020 Enrollment ID: I20180201000039 |
| Provider Name | Bonita L Deloach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649774795 PECOS PAC ID: 7214290865 Enrollment ID: I20180412000009 |
| Provider Name | Victoria K Gonsorcik |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1487876637 PECOS PAC ID: 2062691611 Enrollment ID: I20180507000555 |
| Provider Name | Imtiaz Khurshid |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1740289917 PECOS PAC ID: 6103951900 Enrollment ID: I20180521000979 |
| Provider Name | Douglas Alan Spotts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710954797 PECOS PAC ID: 8921905043 Enrollment ID: I20180521002626 |
| Provider Name | Maria D Merzouk |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811908023 PECOS PAC ID: 6901809573 Enrollment ID: I20180730001488 |
| Provider Name | Ijeoma G Ifeanyi-nwanze |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1205272754 PECOS PAC ID: 7517215130 Enrollment ID: I20180730001982 |
| Provider Name | Pamela S Mullins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740735273 PECOS PAC ID: 8325399207 Enrollment ID: I20180918000281 |
| Provider Name | Rose J Griffin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730560780 PECOS PAC ID: 9436400678 Enrollment ID: I20180926003173 |
| Provider Name | Bryan Jeffrey Peralta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801379490 PECOS PAC ID: 2466704648 Enrollment ID: I20181017000310 |
| Provider Name | Joseph James Schulz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1790921484 PECOS PAC ID: 9537316641 Enrollment ID: I20181113001232 |
| Provider Name | Erin Melissa Oman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891260741 PECOS PAC ID: 4880938125 Enrollment ID: I20181128000063 |
| Provider Name | Katie Schulz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760756522 PECOS PAC ID: 2860796695 Enrollment ID: I20181128003306 |
| Provider Name | Ellyse Lopez Lamont |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326558545 PECOS PAC ID: 1850659293 Enrollment ID: I20190122000426 |
| Provider Name | Aaron Edward George |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770849853 PECOS PAC ID: 7315255759 Enrollment ID: I20190215000994 |
| Provider Name | Lori Jenkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154891000 PECOS PAC ID: 0446599526 Enrollment ID: I20190307001463 |
| Provider Name | Miranda L Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427512318 PECOS PAC ID: 9234479718 Enrollment ID: I20190320000366 |
| Provider Name | Paul J Quesenberry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326043761 PECOS PAC ID: 2769676188 Enrollment ID: I20190426000966 |
| Provider Name | Catherine Feaga |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275844995 PECOS PAC ID: 5799945259 Enrollment ID: I20190510000541 |
| Provider Name | Jennifer Lyn Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023511706 PECOS PAC ID: 4284997800 Enrollment ID: I20190529001997 |
| Provider Name | Mansoor Ahmad |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1184014102 PECOS PAC ID: 4789991092 Enrollment ID: I20190618000033 |
| Provider Name | Christina Maria Scuderi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023670841 PECOS PAC ID: 4789910571 Enrollment ID: I20190801000010 |
| Provider Name | Christopher Graziano |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1619236973 PECOS PAC ID: 4486904620 Enrollment ID: I20190815000022 |
| Provider Name | Adrian Garza-cavazos |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265839179 PECOS PAC ID: 1254669062 Enrollment ID: I20190817000010 |
| Provider Name | Elionore Nkwemou |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467005629 PECOS PAC ID: 4789913518 Enrollment ID: I20190904001932 |
| Provider Name | Vanessa Geyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225694888 PECOS PAC ID: 2466781794 Enrollment ID: I20190911001273 |
| Provider Name | Mohammad M Khan |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1568431849 PECOS PAC ID: 5698843001 Enrollment ID: I20191203000584 |
| Provider Name | Justina C Workman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194361055 PECOS PAC ID: 8921433616 Enrollment ID: I20200128000938 |
| Provider Name | John Battista Maggioncalda |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1346239472 PECOS PAC ID: 3678511342 Enrollment ID: I20200309001737 |
| Provider Name | James F Wachter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396804324 PECOS PAC ID: 7517045966 Enrollment ID: I20200421002325 |
| Provider Name | Philip Corcoran |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1932278983 PECOS PAC ID: 4789786716 Enrollment ID: I20200427000560 |
| Provider Name | Bradley J Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255368130 PECOS PAC ID: 6507866118 Enrollment ID: I20200601000026 |
| Provider Name | Eden T Amdemichael |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1659530509 PECOS PAC ID: 3870854417 Enrollment ID: I20200615002366 |
| Provider Name | Showkat Bashir |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1740242106 PECOS PAC ID: 3274518311 Enrollment ID: I20200702000185 |
| Provider Name | Manminder Singh Bhatia |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1518373182 PECOS PAC ID: 7113144064 Enrollment ID: I20200827000482 |
| Provider Name | Milay Luis Lam |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1205174430 PECOS PAC ID: 3870803836 Enrollment ID: I20201111000903 |
| Provider Name | Britni Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770182693 PECOS PAC ID: 8921419730 Enrollment ID: I20201201000207 |
| Provider Name | Amanda Lee Mohler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154933687 PECOS PAC ID: 2567873235 Enrollment ID: I20201201002915 |
| Provider Name | Julie Louise Paez |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1588265037 PECOS PAC ID: 6608280128 Enrollment ID: I20210125001863 |
| Provider Name | Christopher Walker Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114513223 PECOS PAC ID: 0244645794 Enrollment ID: I20210216002056 |
| Provider Name | Brian Aprill |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1588659023 PECOS PAC ID: 8325936412 Enrollment ID: I20210222000027 |
| Provider Name | Andreas Kaikis |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1811384530 PECOS PAC ID: 9133452972 Enrollment ID: I20210304000204 |
| Provider Name | Brian Cantor |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548314404 PECOS PAC ID: 9234183260 Enrollment ID: I20210324000089 |
| Provider Name | Hillary Theresa Blank |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457947145 PECOS PAC ID: 0840607982 Enrollment ID: I20210407002117 |
| Provider Name | Amy E Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518545300 PECOS PAC ID: 3375952500 Enrollment ID: I20210429001040 |
| Provider Name | Daniel J Deaton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922504273 PECOS PAC ID: 2163760844 Enrollment ID: I20210702002348 |
| Provider Name | Patrick Walker |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1124448162 PECOS PAC ID: 0941591945 Enrollment ID: I20210726001523 |
| Provider Name | Helen Harrington |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306188149 PECOS PAC ID: 8426282377 Enrollment ID: I20210921002172 |
| Provider Name | Michael Gaudiose |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578567939 PECOS PAC ID: 1557555109 Enrollment ID: I20211004000909 |
| Provider Name | Mahinur H. Khan |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1356557169 PECOS PAC ID: 4183790801 Enrollment ID: I20211006002108 |
| Provider Name | Christina Clarissa Poh |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376036673 PECOS PAC ID: 0840680187 Enrollment ID: I20211201000773 |
| Provider Name | Andrew Ditto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841424348 PECOS PAC ID: 8921254020 Enrollment ID: I20211216002614 |
| Provider Name | Gordian Ndubizu |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487016200 PECOS PAC ID: 3476769423 Enrollment ID: I20211222000019 |
| Provider Name | Katie Elizabeth Schleigh |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1992463582 PECOS PAC ID: 9830580604 Enrollment ID: I20220105001664 |
| Provider Name | Patrick Shannon Mcdonough |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1649442682 PECOS PAC ID: 8123260882 Enrollment ID: I20220216000260 |
| Provider Name | Casey Seton Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457015372 PECOS PAC ID: 1153714027 Enrollment ID: I20220217001504 |
| Provider Name | Matthew Malamet |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1275655912 PECOS PAC ID: 6901061431 Enrollment ID: I20220401000068 |
| Provider Name | Cristina Butler-lugo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033865266 PECOS PAC ID: 4789061540 Enrollment ID: I20220517000335 |
| Provider Name | Chiemeka Onyima |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1215460076 PECOS PAC ID: 9537562970 Enrollment ID: I20220616000836 |
| Provider Name | Sabrina Meftali |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1801336466 PECOS PAC ID: 7113340787 Enrollment ID: I20220617000288 |
| Provider Name | Joshua T Adetayo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982339560 PECOS PAC ID: 4486037207 Enrollment ID: I20220812001287 |
| Provider Name | Megan Welty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144955972 PECOS PAC ID: 9335523166 Enrollment ID: I20220829001678 |
| Provider Name | Geoffrey N Sanyi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174028914 PECOS PAC ID: 4284018961 Enrollment ID: I20220830000085 |
| Provider Name | Seemal Awan |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1558715359 PECOS PAC ID: 3678801289 Enrollment ID: I20220922000028 |
| Provider Name | Jianwu Xie |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1144647843 PECOS PAC ID: 9436446424 Enrollment ID: I20221007000906 |
| Provider Name | Amelia Rae Fitts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225751860 PECOS PAC ID: 4183092604 Enrollment ID: I20221115000193 |
| Provider Name | Francesca Ijeoma Okoye |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1992002992 PECOS PAC ID: 8224287941 Enrollment ID: I20221123000494 |
| Provider Name | Fahad Lodhi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1053773176 PECOS PAC ID: 3870826050 Enrollment ID: I20221207000011 |
| Provider Name | Abigail B Kick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982042826 PECOS PAC ID: 1355575978 Enrollment ID: I20221220002729 |
| Provider Name | Bianca Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760068191 PECOS PAC ID: 0244600955 Enrollment ID: I20221221000575 |
| Provider Name | Tracey Renee Higgins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437882511 PECOS PAC ID: 9032580915 Enrollment ID: I20230201001597 |
| Provider Name | Alan Oroxom |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1790770410 PECOS PAC ID: 7618161167 Enrollment ID: I20230221001442 |
| Provider Name | Elizabeth Tomalis |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1689371379 PECOS PAC ID: 5092188532 Enrollment ID: I20230302001857 |
| Provider Name | Todd H Sterling |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1982699849 PECOS PAC ID: 7012137060 Enrollment ID: I20230321000508 |
| Provider Name | Spencer Craven |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1922426071 PECOS PAC ID: 7517293020 Enrollment ID: I20230324000387 |
| Provider Name | Kaitlyn Nicole Spangler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801595384 PECOS PAC ID: 7315311768 Enrollment ID: I20230327000100 |
| Provider Name | Amber Nichole Peck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013614767 PECOS PAC ID: 6406220672 Enrollment ID: I20230330000778 |
| Provider Name | Allison Joy Beall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518664622 PECOS PAC ID: 3870968506 Enrollment ID: I20230412000711 |
| Provider Name | Brittany Leigh Anne Merson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164126918 PECOS PAC ID: 7113382359 Enrollment ID: I20230424000624 |
| Provider Name | Saba Aziz |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1679802805 PECOS PAC ID: 2860632460 Enrollment ID: I20230529000068 |
| Provider Name | Gentian Toshkezi |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1760617054 PECOS PAC ID: 4688924293 Enrollment ID: I20230605000270 |
| Provider Name | Jamie Michelle Hittman |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1609372143 PECOS PAC ID: 4880053370 Enrollment ID: I20230630001259 |
| Provider Name | Brenda L Vitucci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851494488 PECOS PAC ID: 2961491360 Enrollment ID: I20230703000547 |
| Provider Name | Sami Shoucair |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1093166506 PECOS PAC ID: 7416316534 Enrollment ID: I20230707002520 |
| Provider Name | Mckenzie Sorrell |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1184144529 PECOS PAC ID: 1456617695 Enrollment ID: I20230707003242 |
| Provider Name | Chunwei Lai |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1134568306 PECOS PAC ID: 0547554677 Enrollment ID: I20230726001396 |
| Provider Name | Asim Shabbir |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1114388154 PECOS PAC ID: 1658663802 Enrollment ID: I20230804000291 |
| Provider Name | Bernardo Diaz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1609255447 PECOS PAC ID: 6608127576 Enrollment ID: I20230815000027 |
| Provider Name | Marina Overby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194394098 PECOS PAC ID: 3870981061 Enrollment ID: I20230815000056 |
| Provider Name | Arish Noor |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1184158776 PECOS PAC ID: 5496027609 Enrollment ID: I20230829004285 |
| Provider Name | Daniel C Schnurr |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1316478696 PECOS PAC ID: 6901179704 Enrollment ID: I20230905002149 |
| Provider Name | Cassandra Prasad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275174377 PECOS PAC ID: 8921432469 Enrollment ID: I20230907000603 |
| Provider Name | Husayn Ladhani |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1851718902 PECOS PAC ID: 1850685900 Enrollment ID: I20230918000101 |
| Provider Name | Felicia Balzano |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1467830711 PECOS PAC ID: 4688952328 Enrollment ID: I20231107003574 |
| Provider Name | Jennifer Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962182238 PECOS PAC ID: 3173970183 Enrollment ID: I20231114000523 |
| Provider Name | Erin Miller |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811263890 PECOS PAC ID: 5496059719 Enrollment ID: I20231115001336 |
| Provider Name | Matthew M Robinson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1912989369 PECOS PAC ID: 1153233523 Enrollment ID: I20231128002402 |
| Provider Name | Melinda Ann Headley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518637602 PECOS PAC ID: 3173919453 Enrollment ID: I20231130001604 |
| Provider Name | Amy Pelfrey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609277151 PECOS PAC ID: 2860877842 Enrollment ID: I20231202000747 |
| Provider Name | Edward Whitesides |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1033104344 PECOS PAC ID: 0143116939 Enrollment ID: I20231208000260 |
| Provider Name | Rhamee Badr |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1548656531 PECOS PAC ID: 6800297128 Enrollment ID: I20231227001543 |
| Provider Name | Mohammed Kalan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1629077151 PECOS PAC ID: 6800818535 Enrollment ID: I20240102000986 |
| Provider Name | Elizabeth Colleen Taylor |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1912772674 PECOS PAC ID: 5991149320 Enrollment ID: I20240214000151 |
| Provider Name | Alondra Juliana Black |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1710740162 PECOS PAC ID: 0749624898 Enrollment ID: I20240216003455 |
| Provider Name | Chikezie Eseonu |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1528382173 PECOS PAC ID: 0749439263 Enrollment ID: I20240221004153 |
| Provider Name | Maecy C Robertson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1528784881 PECOS PAC ID: 6800231267 Enrollment ID: I20240226002824 |
Dr Francisco L. Andrade Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 350 Mill St, Hagerstown, MD 21740 Phone: 301-739-6620 Fax: 301-739-6628 | |
Massoud B. Alizadeh M.d.,pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 240 Frederick St, Hagerstown, MD 21740 Phone: 301-739-8049 Fax: 301-733-3287 | |
Complete Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 40 Elgin Blvd, Suite 201, Hagerstown, MD 21740 Phone: 240-382-3554 Fax: 301-498-1439 | |
Nms Wellness Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 14014 Marsh Pike, Hagerstown, MD 21742 Phone: 301-733-8700 | |
Privia Medical Group, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13204 Fountain Head Plz, Hagerstown, MD 21742 Phone: 240-215-1138 | |
Robert J Trace Jr Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 121 E Antietam St, Hagerstown, MD 21740 Phone: 301-739-2560 Fax: 301-739-0266 | |
Family First Medical Center And Pharmacy Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13403 Volvo Way, Medical Suite, Hagerstown, MD 21742 Phone: 240-500-3764 Fax: 301-790-2050 |