| Prime Doc Of Haywood, Pa | |
|
262 Leroy George Drive Clyde NC 28721-7430 | |
| (828) 452-8862 | |
| (843) 237-5073 |
| Full Name | Prime Doc Of Haywood, Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 262 Leroy George Drive, Clyde, North Carolina |
| Authorized Official Name and Position | Talbot G. Mccormick (PRESIDENT) |
| Authorized Official Contact | 6784418500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Doc Of Haywood, Pa 5901-c Peachtree Dunwoody Road Suite 350 Atlanta GA 30328-7159 Ph: (678) 441-8556 | Prime Doc Of Haywood, Pa 262 Leroy George Drive Clyde NC 28721-7430 Ph: (828) 452-8862 |
| NPI Number | 1992761886 |
|---|---|
| Provider Enumeration Date | 04/21/2006 |
| Last Update Date | 07/10/2015 |
| Medicare PECOS PAC ID | 1759274285 |
|---|---|
| Medicare Enrollment ID | O20040206000591 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992761886 | NPI | - | NPPES |
| 013PU | Other | NC | BLUE CROSS BLUE SHIELD |
| DC9720 | Other | NC | RAILROAD MEDICARE |
| 89013PU | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Jorge E Polanco |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346211455 PECOS PAC ID: 7416918107 Enrollment ID: I20041026000301 |
| Provider Name | Eric Weiner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780626937 PECOS PAC ID: 0143288985 Enrollment ID: I20061213000480 |
| Provider Name | Arfana A Kishan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457369175 PECOS PAC ID: 7517967474 Enrollment ID: I20070220000407 |
| Provider Name | Marvin D Brauer |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1043219314 PECOS PAC ID: 2769584168 Enrollment ID: I20070716000405 |
| Provider Name | Marina V Levin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1023209798 PECOS PAC ID: 6305938150 Enrollment ID: I20070823000963 |
| Provider Name | Willie E Hester |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730354002 PECOS PAC ID: 9335115054 Enrollment ID: I20090721000737 |
| Provider Name | Wesley Christian Jones |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730289984 PECOS PAC ID: 6709977945 Enrollment ID: I20100123000064 |
| Provider Name | Charles A Fotuchang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477781805 PECOS PAC ID: 1850435413 Enrollment ID: I20100219000521 |
| Provider Name | Mark E Kinter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366434557 PECOS PAC ID: 9537162169 Enrollment ID: I20100316000247 |
| Provider Name | Adrienne E S Stanley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942405618 PECOS PAC ID: 5890829691 Enrollment ID: I20100816000757 |
| Provider Name | Marcel Ikwuoma Akuneme |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1336398387 PECOS PAC ID: 2466577556 Enrollment ID: I20100913000896 |
| Provider Name | Abinet Mulat Boku |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477731248 PECOS PAC ID: 2062567845 Enrollment ID: I20110318000720 |
| Provider Name | Debby Crosley |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1285824961 PECOS PAC ID: 1153404868 Enrollment ID: I20110413000911 |
| Provider Name | Franklin Chinagorom Ohiagbaji |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1972749034 PECOS PAC ID: 4789854365 Enrollment ID: I20110909002635 |
| Provider Name | Chiedozie Eke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669636494 PECOS PAC ID: 9133394158 Enrollment ID: I20111209000506 |
| Provider Name | Kristen Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316049125 PECOS PAC ID: 8527198712 Enrollment ID: I20120111000533 |
| Provider Name | David C Stevens |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740382548 PECOS PAC ID: 6103957253 Enrollment ID: I20120111000547 |
| Provider Name | Joseph Anthony Destefano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508841032 PECOS PAC ID: 4688669526 Enrollment ID: I20120405000651 |
| Provider Name | Benjamin L Glover |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932158201 PECOS PAC ID: 8224075833 Enrollment ID: I20120801000822 |
| Provider Name | Rhianna Ritter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518192814 PECOS PAC ID: 4486800950 Enrollment ID: I20120816000230 |
| Provider Name | David J Hegerich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013164680 PECOS PAC ID: 2668661588 Enrollment ID: I20120913000419 |
| Provider Name | Dawn M Grinenko |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699790527 PECOS PAC ID: 1850425117 Enrollment ID: I20130731000563 |
| Provider Name | Sameera Ahmad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831135805 PECOS PAC ID: 8426290297 Enrollment ID: I20130806000945 |
| Provider Name | Roberto Sanchez Gutierrez |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164625182 PECOS PAC ID: 6608064472 Enrollment ID: I20130904000810 |
| Provider Name | Joyce S Shen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992017867 PECOS PAC ID: 0345476651 Enrollment ID: I20131114001906 |
| Provider Name | Samuel K Kolleh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154635027 PECOS PAC ID: 5092950873 Enrollment ID: I20140326002212 |
| Provider Name | Samuel J Kleiman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407851124 PECOS PAC ID: 8325032956 Enrollment ID: I20150619002208 |
| Provider Name | Omer Zulfiqar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043577059 PECOS PAC ID: 1759697550 Enrollment ID: I20150824002133 |
| Provider Name | Fidelis A Okotie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376856039 PECOS PAC ID: 0547384794 Enrollment ID: I20151028000496 |
| Provider Name | Ndi J Maduako |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396985644 PECOS PAC ID: 4688824584 Enrollment ID: I20160112001273 |
| Provider Name | Jennifer Lee Cunningham |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1770710154 PECOS PAC ID: 8426365743 Enrollment ID: I20160810000841 |
| Provider Name | Elli B Saraceno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154697563 PECOS PAC ID: 3476851403 Enrollment ID: I20160912000666 |
| Provider Name | Aliyi A Aliyi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558700468 PECOS PAC ID: 6507167822 Enrollment ID: I20161024001272 |
Wound Healing And Hyperbaric Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 360 Hospital Dr, Clyde, NC 28721 Phone: 828-213-4600 | |
Appalachian Primary Care, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 107 Haywood Park Dr, Clyde, NC 28721 Phone: 828-237-8001 Fax: 828-237-8002 | |
Haywood Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 490 Hospital Dr, Clyde, NC 28721 Phone: 828-246-6372 | |
Mission Weight Management Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 360 Hospital Dr, Clyde, NC 28721 Phone: 828-213-4100 | |
Haywood Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 16 Physician Dr, Clyde, NC 28721 Phone: 828-456-9836 Fax: 828-452-9814 | |
Mountain Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 600 Hospital Dr, Suite 9, Clyde, NC 28721 Phone: 828-452-0331 Fax: 828-456-6100 | |
Haywood Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 490 Hospital Dr, 2nd Floor, Clyde, NC 28721 Phone: 828-456-9006 |