Stefan Hannevig (NPI# 1790039386, PAC ID# 0143466557) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1790039386 |
| PAC ID by PECOS | 0143466557 |
| Professional Enrollment ID | I20130409000283 |
| Full Name | Stefan Hannevig |
| Organization Legal Name | LIFEBRIDGE COMMUNITY PHYSICIANS INC |
| Address |
5401 Old Court Rd Randallstown MD 21133-5103 |
| Gender | M |
| Graduation Year | 2012 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 3678751468 |
| Number of Group Practice Members | 105 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 210040 | NORTHWEST HOSPITAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 2401 W Belvedere Ave, Lifebridge Critical Care, Baltimore, MD 21215-5216 | 4105215973 | LIFEBRIDGE COMMUNITY PHYSICIANS INC |
| 5401 Old Court Rd, Randallstown, MD 21133-5103 | LIFEBRIDGE COMMUNITY PHYSICIANS INC | |
| 410 Malcolm Dr, Suite A, Westminster, MD 21157-6160 | 4108767772 | LIFEBRIDGE COMMUNITY PHYSICIANS INC |
| Organization Legal Name | LIFEBRIDGE COMMUNITY PHYSICIANS INC |
| Physicians | 109 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stephen Witanowski | Internal Medicine | Lifebridge Community Physicians Inc | 410 Malcolm Dr, Suite A, Westminster, MD 21157-6160 |
| Kimberly S Weiss | Physician Assistant | Lifebridge Community Physicians Inc | 6355 Ten Oaks Rd, Suite 202, Clarksville, MD 21029-1185 |
| Sam A Zamaria | Obstetrics/gynecology | Lifebridge Community Physicians Inc | 118 Shawan Rd, Suite 220, Cockeysville, MD 21030-1318 |
| Ronald L Broadwater Sr. | General Practice | Lifebridge Community Physicians Inc | 688 Poole Rd, Westminster, MD 21157-6166 |
| Ruchira N Thakor | Family Medicine | Lifebridge Community Physicians Inc | 4 W Rolling Crossroads, Suite 100, Catonsville, MD 21228-6280 |
| Charles Phillip Adamo | Family Medicine | Lifebridge Community Physicians Inc | 2629 Riva Rd, Suite 112, Annapolis, MD 21401-7428 |
| Prema Siva | Internal Medicine | Lifebridge Community Physicians Inc | 8871 Gorman Rd, Laurel, MD 20723-5877 |
| Cyrus Hamidi | Family Medicine | Lifebridge Community Physicians Inc | 913 Ridgebrook Rd, Suite 312, Sparks, MD 21152-9457 |
| Elvira Pasmanik | Internal Medicine | Lifebridge Community Physicians Inc | 8600 Liberty Rd, Randallstown, MD 21133-4707 |
| Alexander Bogdaschewskyi | Internal Medicine | Lifebridge Community Physicians Inc | 1011 Baltimore Blvd, Westminster, MD 21157-7055 |
| Street Address |
5401 OLD COURT RD |
| City | RANDALLSTOWN |
| State | MD |
| Zip | 21133-5103 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brian Janz | Hand Surgery | Sinai Hospital of Baltimore, Inc | 5401 Old Court Rd, Randallstown, MD 21133-5103 |
| Jeanpierre Elkhoury | Critical Care (intensivists) | Lifebridge Community Physicians Inc | 5401 Old Court Rd, Randallstown, MD 21133-5103 |
| Kristen Elizabeth Marll | Certified Registered Nurse Anesthetist (crna) | North American Partners In Anesthesia Maryland LLC | 5401 Old Court Rd, Randallstown, MD 21133-5103 |
| Michael G Jones | Physician Assistant | Northwest Hospital Center Inc | 5401 Old Court Rd, Randallstown, MD 21133-5103 |
| Scott W Stromberg | Physician Assistant | Northwest Hospital Center Inc | 5401 Old Court Rd, Randallstown, MD 21133-5103 |
| Tandi J Mohammed | Anesthesiology | North American Partners In Anesthesia Maryland LLC | 5401 Old Court Rd, Randallstown, MD 21133-5103 |
| Marcie B Feinman | General Surgery | Sinai Hospital of Baltimore, Inc | 5401 Old Court Rd, Randallstown, MD 21133-5103 |
| Laura J Robertson | Diagnostic Radiology | Fands Radiology PC | 5401 Old Court Rd, Randallstown, MD 21133-5103 |
| Devorah Howell | Nurse Practitioner | Lifebridge Community Physicians Inc | 5401 Old Court Rd, Randallstown, MD 21133-5103 |
| Shira Khoshkerman | Physician Assistant | Northwest Hospital Center Inc | 5401 Old Court Rd, Randallstown, MD 21133-5103 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| S Marc Testa | Psychologist, Clinical | Sinai Hospital of Baltimore, Inc | 5401 W Belvedere Ave, Sinai Oncology Associates, Randallstown, MD 21133 |
| Eugene Meyer | General Surgery | 5401 Old Court, Randallstown, MD 21133 | |
| Rachel O Adejoh | Nurse Practitioner | 3669 Offutt Rd, Randallstown, MD 21133-3515 | |
| Veronica A Holland-barner | Nurse Practitioner | 3927 Mcdonogh Rd, Randallstown, MD 21133-3633 | |
| Angel V Shannon | Nurse Practitioner | 9133 Sunset Ridge Rd, Randallstown, MD 21133-3651 | |
| Winter Chanal Wesley | Clinical Social Worker | 9026 Allenswood Rd, Randallstown, MD 21133-3731 | |
| Donald J Hayes | General Practice | 9012 Liberty Rd, Randallstown, MD 21133-3910 | |
| Crystal Greene | Nurse Practitioner | 8632 Windmill Rd, Randallstown, MD 21133-4445 | |
| Angela A Swinson | Preventative Medicine | Ms-hc LLC | 8608 Liberty Rd, Randallstown, MD 21133-4707 |
| Elvira Pasmanik | Internal Medicine | Lifebridge Community Physicians Inc | 8600 Liberty Rd, Randallstown, MD 21133-4707 |
| Find all physicians in zip 21133 | |||
| City | RANDALLSTOWN |
| Zip Code | 21133 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | RANDALLSTOWN + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Stefan Hannevig.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.