Carl R Dettwiler (NPI# 1285623819, PAC ID# 2769457852) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GASTROENTEROLOGY.
| Nation Provider ID (NPI) | 1285623819 |
| PAC ID by PECOS | 2769457852 |
| Professional Enrollment ID | I20040907000488 |
| Full Name | Carl R Dettwiler |
| Address |
2517 17th St B Lewiston ID 83501-6311 |
| Gender | M |
| Credential | MD |
| Medical School | LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1981 |
| Primary Specialty | GASTROENTEROLOGY |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 501332 | TRI-STATE MEMORIAL HOSPITAL |
| 130003 | ST JOSEPH REGIONAL MEDICAL CENTER |
| 131315 | SYRINGA GENERAL HOSPITAL |
| 131321 | ST MARYS HOSPITAL AND CLINICS |
| Address | Phone | Organization |
|---|---|---|
| 1221 Highland Ave, Clarkston, WA 99403-2829 | ||
| 2517 17th St B, Lewiston, ID 83501-6311 |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_320_overall | Appropriate Follow-Up Interval for Normal Colonoscopy in Average Risk Patients | 100% | |
| QCDR_EC_GIQIC10_overall | Appropriate management of anticoagulation in the peri-procedural period rate – EGD | 99% | |
| QCDR_EC_GIQIC12_overall | Appropriate indication for colonoscopy | 95% |
| Street Address |
2517 17TH ST B |
| City | LEWISTON |
| State | ID |
| Zip | 83501-6311 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Linda K Dewitt | Nurse Practitioner | Clearwater Gastroenterology | 2517 17th St B, Lewiston, ID 83501-6311 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lori L Holder | Clinical Social Worker | 504 Main St, Suite 472, Lewiston, ID 83501-1806 | |
| Thomas R Boyer | Chiropractic | 717 D St, Lewiston, ID 83501-1826 | |
| Rebecca A Bohnenkamp | Clinical Social Worker | 523 /2 Main St, Suite 7, Lewiston, ID 83501-1870 | |
| Kristy Anne Kuehfuss | Psychologist, Clinical | 633 Main St, Suite B2, Lewiston, ID 83501-1882 | |
| Clinton R Morgan | Hematology/oncology | St Joseph Hospital LLC | 1250 Idaho St, Lewiston, ID 83501-1965 |
| Alice Myra Forsythe | Medical Oncology | St Joseph Hospital LLC | 1250 Idaho St, Lewiston, ID 83501-1965 |
| John Siebel | Hematology/oncology | St Joseph Hospital LLC | 1250 Idaho St, Lewiston, ID 83501-1965 |
| Michele R Dickison | Nurse Practitioner | St Joseph Hospital LLC | 1250 Idaho St, Lewiston, ID 83501-1965 |
| Debra L Street | Clinical Social Worker | 0309 2nd St, Lewiston, ID 83501-2163 | |
| Mark F Yama | Psychologist, Clinical | 428 6th Ave, Lewiston, ID 83501-2355 | |
| Find all physicians in zip 83501 | |||
| City | LEWISTON |
| Zip Code | 83501 |
| Specialty | GASTROENTEROLOGY |
| City + Specialty | LEWISTON + GASTROENTEROLOGY |
Please comment or provide details below to improve the information on Carl R Dettwiler.
| 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.