Edmund Matthew Sciullo Iii (NPI# 1063437440, PAC ID# 5597651992) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is EMERGENCY MEDICINE.
| Nation Provider ID (NPI) | 1063437440 |
| PAC ID by PECOS | 5597651992 |
| Professional Enrollment ID | I20130320000397 |
| Full Name | Edmund Matthew Sciullo Iii |
| Organization Legal Name | WILDWOOD EMERGENCY GROUP, LLC |
| Address |
3700 S Main St Blacksburg VA 24060-7017 |
| Phone Number | 5409511111 |
| Gender | M |
| Credential | DO |
| Medical School | PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE |
| Graduation Year | 1999 |
| Primary Specialty | EMERGENCY MEDICINE |
| Group Practice PAC ID | 4789932385 |
| Number of Group Practice Members | 13 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490110 | LEWISGALE HOSPITAL MONTGOMERY |
| Address | Phone | Organization |
|---|---|---|
| 3700 S Main St, Blacksburg, VA 24060-7017 | 5409511111 | WILDWOOD EMERGENCY GROUP, LLC |
| Organization Legal Name | WILDWOOD EMERGENCY GROUP, LLC |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kristie Jackson | Nurse Practitioner | Wildwood Emergency Group, LLC | 3700 S Main St, Blacksburg, VA 24060-7017 |
| David H Lander | Emergency Medicine | Wildwood Emergency Group, LLC | 3700 S Main St, Blacksburg, VA 24060-7017 |
| Brian D Ekey | Emergency Medicine | Wildwood Emergency Group, LLC | 3700 S Main St, Blacksburg, VA 24060-7017 |
| Jessica Pope Flinchum | Emergency Medicine | Wildwood Emergency Group, LLC | 3700 S Main St, Blacksburg, VA 24060-7017 |
| Jessica B Scruggs | Nurse Practitioner | Wildwood Emergency Group, LLC | 3700 S Main St, Blacksburg, VA 24060-7017 |
| Milissa Diane Smith | Nurse Practitioner | Wildwood Emergency Group, LLC | 3700 S Main St, Blacksburg, VA 24060-7017 |
| Laura Harvey | Emergency Medicine | Wildwood Emergency Group, LLC | 3700 S Main St, Blacksburg, VA 24060-7017 |
| Tracy L Zikes | Nurse Practitioner | Wildwood Emergency Group, LLC | 3700 S Main St, Blacksburg, VA 24060-7017 |
| Street Address |
3700 S MAIN ST |
| City | BLACKSBURG |
| State | VA |
| Zip | 24060-7017 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Peter Joseph Recupero | Internal Medicine | Wildwood Physician Services LLC | 3700 S Main St, Blacksburg, VA 24060-7017 |
| Michael R Aronson | Diagnostic Radiology | Montgomery Radiology Associates Inc | 3700 S Main St, Blacksburg, VA 24060-7017 |
| Kristie Jackson | Nurse Practitioner | Wildwood Emergency Group, LLC | 3700 S Main St, Blacksburg, VA 24060-7017 |
| Whitney Lynn Bateman | Certified Registered Nurse Anesthetist (crna) | Valley Anesthesia PC | 3700 S Main St, Blacksburg, VA 24060-7017 |
| John B Patterson | Cardiovascular Disease (cardiology) | Lewis Gale Physicians LLC | 3700 S Main St, Blacksburg, VA 24060-7017 |
| David H Lander | Emergency Medicine | Wildwood Emergency Group, LLC | 3700 S Main St, Blacksburg, VA 24060-7017 |
| John Paul Jones | Cardiovascular Disease (cardiology) | Lewis Gale Physicians LLC | 3700 S Main St, Blacksburg, VA 24060-7017 |
| Jeffrey A. Forbes | Anesthesiology | Valley Anesthesia PC | 3700 S Main St, Blacksburg, VA 24060-7017 |
| Charles E Clark Iv | Anesthesiology | Valley Anesthesia PC | 3700 S Main St, Blacksburg, VA 24060-7017 |
| Wesley A Robinson | Certified Registered Nurse Anesthetist (crna) | Valley Anesthesia PC | 3700 S Main St, Blacksburg, VA 24060-7017 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gwendolyn W Spangler | Nurse Practitioner | Oncology and Hematology Associates of Southwest Virginia, Inc. | 2600 Research Dr A, Blacksburg, VA 24060 |
| Kristopher Joel Hansen | Hematology/oncology | Oncology and Hematology Associates of Southwest Virginia, Inc. | 2600 Research Dr A, Blacksburg, VA 24060 |
| Michele Lee Keesling | Nurse Practitioner | Oncology and Hematology Associates of Southwest Virginia, Inc. | 2600 Research Dr A, Blacksburg, VA 24060 |
| Charlene M Jordan | Nurse Practitioner | Oncology and Hematology Associates of Southwest Virginia, Inc. | 2600 Research Dr A, Blacksburg, VA 24060 |
| Amy Ratcliffe Butler | Nurse Practitioner | Oncology and Hematology Associates of Southwest Virginia, Inc. | 2600 Research Dr A, Blacksburg, VA 24060 |
| Heather L Bayless | Nurse Practitioner | Oncology and Hematology Associates of Southwest Virginia, Inc. | 2600 Research Dr A, Blacksburg, VA 24060 |
| Mazen I Madhoun | Family Medicine | 3400 Southpoint Dr, Blacksburg, VA 24060-1261 | |
| Glenda Beekmann Ball | Nurse Practitioner | Family Medicine of Blacksburg, LLC | 1645 N Main St, Blacksburg, VA 24060-2554 |
| Avery M Matthews | Psychiatry | Family Medicine of Blacksburg, LLC | 1645 N Main St, Blacksburg, VA 24060-2554 |
| Lynn M Bever | Psychologist, Clinical | 1501 Lark Ln, Blacksburg, VA 24060-2658 | |
| Find all physicians in zip 24060 | |||
| City | BLACKSBURG |
| Zip Code | 24060 |
| Specialty | EMERGENCY MEDICINE |
| City + Specialty | BLACKSBURG + EMERGENCY MEDICINE |
Please comment or provide details below to improve the information on Edmund Matthew Sciullo Iii.
| 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.