Edward Knight Pavillard (NPI# 1548222979, PAC ID# 5799705646) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is VASCULAR SURGERY.
| Nation Provider ID (NPI) | 1548222979 |
| PAC ID by PECOS | 5799705646 |
| Professional Enrollment ID | I20051207000014 |
| Full Name | Edward Knight Pavillard |
| Organization Legal Name | MAIN LINE VASCULAR INSTITUTE LLC |
| Address |
700 S Henderson Rd Suite 304a King of Prussia PA 19406-3530 |
| Phone Number | 4848085220 |
| Gender | M |
| Credential | DO |
| Medical School | PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE |
| Graduation Year | 1999 |
| Primary Specialty | VASCULAR SURGERY |
| Secondary Specialties | GENERAL SURGERY, THORACIC SURGERY |
| Group Practice PAC ID | 6709105000 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 390123 | POTTSTOWN HOSPITAL |
| 390127 | PHOENIXVILLE HOSPITAL |
| 390044 | READING HOSPITAL |
| 390096 | ST JOSEPH MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 700 S Henderson Rd, Suite 304a, King of Prussia, PA 19406-3530 | 4848085220 | MAIN LINE VASCULAR INSTITUTE LLC |
| Organization Legal Name | MAIN LINE VASCULAR INSTITUTE LLC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nessa Nora Quane | Nurse Practitioner | Main Line Vascular Institute LLC | 700 S Henderson Rd, Suite 304a, King of Prussia, PA 19406-3530 |
| Jennifer K Nymark | Nurse Practitioner | Main Line Vascular Institute LLC | 700 S Henderson Rd, Suite 304a, King of Prussia, PA 19406-3530 |
| Street Address |
700 S HENDERSON RD SUITE 304A |
| City | KING OF PRUSSIA |
| State | PA |
| Zip | 19406-3530 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shivani Dua | Physical Medicine and Rehabilitation | Roy M Lerman Md PC | 700 S Henderson Rd, Suite 308c, King of Prussia, PA 19406-4206 |
| Marc S Effron | Physical Medicine and Rehabilitation | Roy M Lerman Md PC | 700 S Henderson Rd, Suite 308c, King of Prussia, PA 19406-4206 |
| Scott J Davidoff | Physical Medicine and Rehabilitation | Roy M Lerman Md PC | 700 S Henderson Rd, Suite 308c, King of Prussia, PA 19406-4206 |
| Angela Marie Nicholas | Family Medicine | Fornance Physician Services Inc | 700 S Henderson Rd, Suite 306, King of Prussia, PA 19406-4208 |
| Charissa Myers | Family Medicine | Fornance Physician Services Inc | 700 S Henderson Rd, Suite 306, King of Prussia, PA 19406-4208 |
| Denis P Rogers | Physical Medicine and Rehabilitation | Roy M Lerman Md PC | 700 S Henderson Rd, Suite 308c, King of Prussia, PA 19406-4206 |
| Kimberly Richardson | Family Medicine | Fornance Physician Services Inc | 700 S Henderson Rd, Suite 306, King of Prussia, PA 19406-4208 |
| Andrew A Badulak | Family Medicine | Roy M Lerman Md PC | 700 S Henderson Rd, Suite 308c, King of Prussia, PA 19406-4206 |
| Nessa Nora Quane | Nurse Practitioner | Main Line Vascular Institute LLC | 700 S Henderson Rd, Suite 304a, King of Prussia, PA 19406-3530 |
| P. Michael Glowacki | Family Medicine | Fornance Physician Services Inc | 700 S Henderson Rd, Suite 306, King of Prussia, PA 19406-4208 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cari D Cinamella | Optometry | Delaware Valley Vision Associates Group Practice LLC | 200 Mall Boulevard, King of Prussia, PA 19406 |
| Ketki Soin | Ophthalmology | Delaware Valley Vision Associates Group Practice LLC | 200 Mall Boulevard, King of Prussia, PA 19406 |
| Sandhya S Ramsook | Optometry | Delaware Valley Vision Associates Group Practice LLC | 200 Mall Boulevard, King of Prussia, PA 19406 |
| Tanja Moennichmeyer | Optometry | Delaware Valley Vision Associates Group Practice LLC | 200 Mall Boulevard, King of Prussia, PA 19406 |
| Jurij R Bilyk | Ophthalmology | Delaware Valley Vision Associates Group Practice LLC | 200 Mall Boulevard, King of Prussia, PA 19406 |
| Anthony Zacchei | Ophthalmology | Delaware Valley Vision Associates Group Practice LLC | 200 Mall Boulevard, King of Prussia, PA 19406 |
| Aaron D Cohn | Ophthalmology | Delaware Valley Vision Associates Group Practice LLC | 200 Mall Boulevard, King of Prussia, PA 19406 |
| Michael Allan Aronsky | Ophthalmology | Delaware Valley Vision Associates Group Practice LLC | 200 Mall Boulevard, King of Prussia, PA 19406 |
| Jacquelyn Repice | Occupational Therapy | Full Range Physical Therapy, LLC | 10102 Valley Forge Cir, Suite 102a, King of Prussia, PA 19406-1111 |
| Sarah Marlene Derr | Optometry | The Elder Eye Care Group, Inc | 10106 Valley Forge Cir, King of Prussia, PA 19406-1111 |
| Find all physicians in zip 19406 | |||
| City | KING OF PRUSSIA |
| Zip Code | 19406 |
| Specialty | VASCULAR SURGERY |
| City + Specialty | KING OF PRUSSIA + VASCULAR SURGERY |
Please comment or provide details below to improve the information on Edward Knight Pavillard.
| 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.