Susquehanna Physician Services | |
700 High Street Williamsport PA 17701-3198 | |
(570) 321-2181 | |
(570) 321-2182 |
Full Name | Susquehanna Physician Services |
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Speciality | Internal Medicine |
Location | 700 High Street, Williamsport, Pennsylvania |
Authorized Official Name and Position | Melissa Davis (VP/COO) |
Authorized Official Contact | 5703207696 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Susquehanna Physician Services 1201 Grampian Blvd Williamsport PA 17701-1900 Ph: () - | Susquehanna Physician Services 700 High Street Williamsport PA 17701-3198 Ph: (570) 321-2181 |
NPI Number | 1255363354 |
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Provider Enumeration Date | 07/07/2006 |
Last Update Date | 10/20/2015 |
Medicare PECOS PAC ID | 2264336460 |
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Medicare Enrollment ID | O20040702000879 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255363354 | NPI | - | NPPES |
880746 | Other | PA | HIGHMARK BLUE SHIELD |
0017300760156 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
Provider Name | Roman Alfred Tuma |
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Provider Type | Practitioner - Infectious Disease |
Provider Identifiers | NPI Number: 1134129612 PECOS PAC ID: 2769450097 Enrollment ID: I20040923000628 |
Provider Name | Christian O Perez |
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Provider Type | Practitioner - Infectious Disease |
Provider Identifiers | NPI Number: 1881985695 PECOS PAC ID: 5193027704 Enrollment ID: I20161021000577 |
Provider Name | Alex Marshal Trzebucki |
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Provider Type | Practitioner - Infectious Disease |
Provider Identifiers | NPI Number: 1114269594 PECOS PAC ID: 9739471533 Enrollment ID: I20200709000017 |
Provider Name | Curran Steven Perry |
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Provider Type | Practitioner - Infectious Disease |
Provider Identifiers | NPI Number: 1386105393 PECOS PAC ID: 6608103502 Enrollment ID: I20240906000906 |
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