Samuel Dean Detweiler (NPI# 1437299237, PAC ID# 6103979489) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1437299237 |
| PAC ID by PECOS | 6103979489 |
| Professional Enrollment ID | I20090804000421 |
| Full Name | Samuel Dean Detweiler |
| Organization Legal Name | ST. MARY'S HEALTHCARE |
| Address |
331 Bridge St Northville NY 12134-7418 |
| Phone Number | 5188634200 |
| Gender | M |
| Graduation Year | 1981 |
| Primary Specialty | FAMILY MEDICINE |
| Secondary Specialties | GENERAL PRACTICE |
| Group Practice PAC ID | 7618960709 |
| Number of Group Practice Members | 77 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 330047 | ST MARY'S HEALTHCARE |
| 330276 | NATHAN LITTAUER HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 331 Bridge St, Northville, NY 12134-7418 | 5188634200 | ST. MARY'S HEALTHCARE |
| Organization Legal Name | ST. MARY'S HEALTHCARE |
| Physicians | 72 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennifer Mehling | Nurse Practitioner | St. Mary's Healthcare | 700 S Perry St, Johnstown, NY 12095-3213 |
| Chelsea Centurioni | Physician Assistant | St. Mary's Healthcare | 427 Guy Park Ave, Amsterdam, NY 12010-1054 |
| James Izzano | Obstetrics/gynecology | St. Mary's Healthcare | 446 A Guy Park Ave, Amsterdam, NY 12010-1005 |
| Athanasios Tournas | Otolaryngology | St. Mary's Healthcare | 380 Guy Park Ave, Amsterdam, NY 12010-1055 |
| Deborah A Sculco | Hematology/oncology | St. Mary's Healthcare | 4988 State Hwy 30, Amsterdam, NY 12010-7520 |
| Brij M Saran | Psychiatry | St. Mary's Healthcare | 57 E Fulton St, Gloversville, NY 12078-3212 |
| Mohammad-reza Ghazi-moghadam | Urology | St. Mary's Healthcare | 425 Guy Park Ave, Amsterdam, NY 12010-1043 |
| Judith N Kelly | Nurse Practitioner | St. Mary's Healthcare | 48 Erie Blvd, Canajoharie, NY 13317-1133 |
| Craig E Todd | Emergency Medicine | St. Mary's Healthcare | 4950 State Hwy 30, Amsterdam, NY 12010-7520 |
| Albert A Fraser | Anesthesiology | St. Mary's Healthcare | 427 Guy Park Ave, Amsterdam, NY 12010-1054 |
| Street Address |
331 BRIDGE ST |
| City | NORTHVILLE |
| State | NY |
| Zip | 12134-7418 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| George E Dasher | Family Practice | St. Mary's Healthcare | 331 Bridge St, Northville, NY 12134 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Hanna Halloran | Physical Therapy | 174 S Main St, Northville, NY 12134-4250 |
| City | NORTHVILLE |
| Zip Code | 12134 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | NORTHVILLE + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Samuel Dean Detweiler.
| 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.