Grant J Shevchik (NPI# 1275501793, PAC ID# 1254528458) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
Nation Provider ID (NPI) | 1275501793 |
PAC ID by PECOS | 1254528458 |
Professional Enrollment ID | I20101214000999 |
Full Name | Grant J Shevchik |
Organization Legal Name | CONCORDIA PHYSICIAN PRACTICE |
Address |
112 Marwood Rd Suite 5000 Cabot PA 16023-2264 |
Phone Number | 7243524448 |
Gender | M |
Medical School | UNIVERSITY OF PENNSYLVANIA SCHOOL OF MEDICINE |
Graduation Year | 1978 |
Primary Specialty | FAMILY MEDICINE |
Secondary Specialties | GERIATRIC MEDICINE |
Group Practice PAC ID | 8820300387 |
Number of Group Practice Members | 4 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
390168 | BUTLER MEMORIAL HOSPITAL |
390032 | ALLEGHENY VALLEY HOSPITAL |
Address | Phone | Organization |
---|---|---|
112 Marwood Rd, Suite 5000, Cabot, PA 16023-2264 | 7243524448 | CONCORDIA PHYSICIAN PRACTICE |
Organization Legal Name | CONCORDIA PHYSICIAN PRACTICE |
Physicians | 5 |
Name | Specialty | Organization | Address |
---|---|---|---|
Daniel P Mcknight | Nurse Practitioner | Concordia Physician Practice | 112 Marwood Rd, Suite 5000, Cabot, PA 16023-2264 |
Marie C Moreau | Nurse Practitioner | Concordia Physician Practice | 112 Marwood Rd, Suite 5000, Cabot, PA 16023-2264 |
Dina Cecere Dosch | Internal Medicine | Concordia Physician Practice | 112 Marwood Rd, Suite 5000, Cabot, PA 16023-2264 |
Fred K Fioravanti | Family Practice | Concordia Physician Practice | 112 Marwood Rd, Cabot, PA 16023-2264 |
Street Address |
112 MARWOOD RD SUITE 5000 |
City | CABOT |
State | PA |
Zip | 16023-2264 |
Name | Specialty | Organization | Address |
---|---|---|---|
Daniel P Mcknight | Nurse Practitioner | Concordia Physician Practice | 112 Marwood Rd, Suite 5000, Cabot, PA 16023-2264 |
Marie C Moreau | Nurse Practitioner | Concordia Physician Practice | 112 Marwood Rd, Suite 5000, Cabot, PA 16023-2264 |
Dina Cecere Dosch | Internal Medicine | Concordia Physician Practice | 112 Marwood Rd, Suite 5000, Cabot, PA 16023-2264 |
Fred K Fioravanti | Family Practice | Concordia Physician Practice | 112 Marwood Rd, Cabot, PA 16023-2264 |
Name | Specialty | Organization | Address |
---|---|---|---|
Lilian Shotts | Nurse Practitioner | Wound Healing Solutions Pennsylvania and Delaware LLC | 134 Marwood Rd, Cabot, PA 16023-2206 |
City | CABOT |
Zip Code | 16023 |
Specialty | FAMILY MEDICINE |
City + Specialty | CABOT + FAMILY MEDICINE |
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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.