MR. MICHAEL M DUTKEVICZ (NPI# 1902803331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902803331 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL M DUTKEVICZ |
| Credential | PA-C |
| Practice Address |
135 Professional Pl Bridgeport WV 26330-4509 |
| Practice Telephone | 6813423680 |
| Practice Fax Number | 6813423665 |
| Mailing Telephone | 6813423680 |
| Mailing Fax Number | 6813423665 |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2015-05-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1809 | WV | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0070754 | 05 |
| Street Address |
135 PROFESSIONAL PL |
| City | BRIDGEPORT |
| State | WV |
| Zip Code | 26330-4509 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700139045 | Salvatore Marino | Physician Assistant | 135 Professional Pl, Bridgeport, WV 26330-4509 | 2012-10-24 |
| 1407115876 | Viacheslav Iremashvili | Urology | 135 Professional Pl, Bridgeport, WV 26330-4509 | 2012-05-04 |
| 1558636274 | Laura E Potesta | Physician Assistant | 135 Professional Pl, Bridgeport, WV 26330-4509 | 2012-03-13 |
| 1023337193 | United Hospital Center, Inc | Urology | 135 Professional Pl, Bridgeport, WV 26330-4509 | 2010-05-27 |
| 1851555460 | Oluyemi Akin-olugbade | Urology | 135 Professional Pl, Bridgeport, WV 26330-4509 | 2008-07-12 |
| 1407881535 | Grant L Franklin Jr. | Urology | 135 Professional Pl, Bridgeport, WV 26330-4509 | 2006-07-11 |
| 1467405217 | William Tuong | Urology | 135 Professional Pl, Bridgeport, WV 26330-4509 | 2006-05-19 |
| 1821082272 | Scott K Luttge | Urology | 135 Professional Pl, Bridgeport, WV 26330-4509 | 2005-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303036 | Gage Mackenzie Chichester | Nurse Anesthetist, Certified Registered | 2673 Medical Park Drive, Bridgeport, WV 26330 | 2020-10-12 |
| 1851914105 | Melany Langhurst | Social Worker | 64 Professional Place, Suite 102, Bridgeport, WV 26330 | 2020-05-21 |
| 1245704980 | Adam Christopher Stonestreet | Social Worker | Community Care of Bridgeport, 65 Professional Place, Bridgeport, WV 26330 | 2019-01-16 |
| 1588146658 | Bridgeport Physical Therapy Services, Inc. | Occupational Therapist | 25 Sweetbrier Lane, Suite 105, Bridgeport, WV 26330 | 2018-09-05 |
| 1275040685 | White Oaks Assisted Living | Assisted Living Facility | 140 Professional Place White Oaks, Bridgeport, WV 26330 | 2018-01-08 |
| 1275049371 | Regional Eye Associates, Inc | Ophthalmology | 220 Southview Drive, Bridgeport, WV 26330 | 2017-12-27 |
| 1528586187 | Savanna Tamia Brown | Social Worker | 65 Professinal Place Suites 101,102103, Bridgeport, WV 26330 | 2017-09-05 |
| 1184079642 | Karla Kay Rinehart | Social Worker | 27 Trovato St., Suite 103, Bridgeport, WV 26330 | 2016-05-03 |
| 1396176756 | Willo Group LLC | Pharmacy | 460 E. Main Street, Bridgeport, WV 26330 | 2013-12-10 |
| 1891031878 | Sherri Michelle Dobson | Occupational Therapy Assistant | 1000 Maplewood Dr, Bridgeport, WV 26330 | 2012-12-20 |
| Find all providers in zip 26330 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720617889 | Keri Bedillion | Physician Assistant | 527 Medical Park Dr Ste 306, Bridgeport, WV 26330-9010 | 2020-04-02 |
| 1114583291 | Steven K Struthers | Physician Assistant | 93 Lance Cir, Bridgeport, CT 06606-1046 | 2019-05-14 |
| 1588229645 | Alexander Daniel Ohlson | Physician Assistant | 46 Newton St, Bridgeport, CT 06605-3306 | 2019-05-04 |
| 1114418365 | Jona Bumci | Physician Assistant | 3180 Main St Ste 304, Bridgeport, CT 06606 | 2018-05-23 |
| 1699158170 | Cortney Davis | Physician Assistant | 3250 Fairfield Ave, Unit 217, Bridgeport, CT 06605 | 2015-07-02 |
| 1861821209 | Andrea Megan Deloera | Physician Assistant | 808 Ww Ray Cir, Bridgeport, TX 76426-2061 | 2013-11-06 |
| 1093023681 | Robert Joseph Scherl | Physician Assistant | Bldg #3005 S.r. 108, Naval Hospital Branch Clinic, Bridgeport, Bridgeport, CA 93517 | 2010-09-17 |
| 1457480022 | James D Stalnaker | Physician Assistant | 527 Medical Park Dr Ste 401, Bridgeport, WV 26330-9010 | 2007-03-02 |
| 1740331024 | Brandi Linette Hicks | Physician Assistant | 47053 Al Highway 277, Suite C, Bridgeport, AL 35740-7205 | 2007-01-15 |
| 1114033867 | William Douglas Todd | Physician Assistant | 221 Twin Lakes Road, Bridgeport, CA 93517-0535 | 2006-08-22 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 26330 |
Please comment or provide details below to improve the information on MR. MICHAEL M DUTKEVICZ.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.