Daniel J Dudrick (NPI# 1003825506, PAC ID# 6507865623) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1003825506 |
| PAC ID by PECOS | 6507865623 |
| Professional Enrollment ID | I20091113000276 |
| Full Name | Daniel J Dudrick |
| Organization Legal Name | INTERMOUNTAIN MEDICAL GROUP INC |
| Address |
610 Wyoming Ave Suite 2 Kingston PA 18704-3702 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF PENNSYLVANIA SCHOOL OF MEDICINE |
| Graduation Year | 2001 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 7810894987 |
| Number of Group Practice Members | 73 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 390137 | WILKES-BARRE GENERAL HOSPITAL |
| 390270 | GEISINGER WYOMING VALLEY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 610 Wyoming Ave, Suite 2, Kingston, PA 18704-3702 | INTERMOUNTAIN MEDICAL GROUP INC | |
| 618 Wyoming Ave, Kingston, PA 18704-3702 | 5702839063 | INTERMOUNTAIN MEDICAL GROUP INC |
| 239 S Mountain Blvd, Mountain Top, PA 18707-1911 | INTERMOUNTAIN MEDICAL GROUP INC |
| Organization Legal Name | INTERMOUNTAIN MEDICAL GROUP INC |
| Physicians | 69 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daniel Rittenberg | Urology | Intermountain Medical Group Inc | 423 3rd Ave, Suite B, Kingston, PA 18704-5809 |
| Tarah Zajaczkowski | Physician Assistant | Intermountain Medical Group Inc | 16 Luzerne Ave, Suite 125, West Pittston, PA 18643-2817 |
| Kelly Sabaluski | Nurse Practitioner | Intermountain Medical Group Inc | 445 Wyoming Ave, Kingston, PA 18704-3601 |
| Kelly Babinski | Nurse Practitioner | Intermountain Medical Group Inc | 743 Jefferson Ave, Suite 203, Scranton, PA 18510-1638 |
| Kevin K Musto | Internal Medicine | Intermountain Medical Group Inc | 901 Wyoming Ave, West Pittston, PA 18643-2742 |
| Fred Usoh | Anesthesiology | Intermountain Medical Group Inc | 468 Northampton St, Kingston, PA 18704-4566 |
| Kimberly T Serine | Physician Assistant | Intermountain Medical Group Inc | 1099 S Township Blvd, Pittston, PA 18640-3247 |
| Noelle Altavilla | Registered Dietitian Or Nutrition Professional | Intermountain Medical Group Inc | 2 Poplar St, Kingston, PA 18704-3709 |
| Kamlesh R Patel | Internal Medicine | Intermountain Medical Group Inc | 500 Scott St, Wilkes Barre, PA 18702-5616 |
| Marnetta S Bradford | Nurse Practitioner | Intermountain Medical Group Inc | 665 Carey Ave, Hanover Township, PA 18706-5466 |
| Street Address |
610 WYOMING AVE SUITE 2 |
| City | KINGSTON |
| State | PA |
| Zip | 18704-3702 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Patrick C Kilduff | Internal Medicine | Intermountain Medical Group Inc | 610 Wyoming Ave, Suite 2, Kingston, PA 18704-3702 |
| Mark Puffenberger | Family Medicine | Intermountain Medical Group Inc | 610 Wyoming Ave, Suite 2, Kingston, PA 18704-3702 |
| Soohan Mansuri | Family Medicine | Intermountain Medical Group Inc | 610 Wyoming Ave, Suite 2, Kingston, PA 18704-3702 |
| Jason R Klem | Physician Assistant | Intermountain Medical Group Inc | 610 Wyoming Ave, Suite 2, Kingston, PA 18704-3702 |
| Devon P Woolfolk | Physician Assistant | Intermountain Medical Group Inc | 610 Wyoming Ave, Suite 2, Kingston, PA 18704-3702 |
| Dustin S Hobbs | Physician Assistant | Intermountain Medical Group Inc | 610 Wyoming Ave, Suite 2, Kingston, PA 18704-3702 |
| David F Rimple | Cardiovascular Disease (cardiology) | 610 Wyoming Ave, Kingston, PA 18704-3702 | |
| Amanda Marie Ettinger | Nurse Practitioner | Intermountain Medical Group Inc | 610 Wyoming Ave, Suite 2, Kingston, PA 18704-3702 |
| William David Hottenstein | Internal Medicine | Intermountain Medical Group Inc | 610 Wyoming Ave, Suite 2, Kingston, PA 18704-3702 |
| Krishnakant A Patel | Family Medicine | Intermountain Medical Group Inc | 610 Wyoming Ave, Suite 2, Kingston, PA 18704-3702 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James W Galasso Iii | Family Medicine | 1200 Main St, Swoyersville, PA 18704-1318 | |
| Paul Latzko | Family Medicine | Medexpress Urgent Care PC - Pennsylvania | 276 W Side Mall, Edwardsville, PA 18704-3117 |
| Frances A Feudale | Emergency Medicine | Medexpress Urgent Care PC - Pennsylvania | 276 W Side Mall, Edwardsville, PA 18704-3117 |
| Vincent Bernard Turosky | Chiropractic | Turosky Chiropractic Clinic, PC | 420 Main St, Edwardsville, PA 18704-3232 |
| John H Turosky | Chiropractic | Turosky Chiropractic Clinic, PC | 420 Main St, Edwardsville, PA 18704-3232 |
| Arthur B Mitchell | Family Medicine | 141 S Maple Ave, Kingston, PA 18704-3310 | |
| John Alaimo | Chiropractic | 180 United Penn Plz, Kingston, PA 18704-3417 | |
| Robert Eli Brown | Optometry | 693 W Market St, Kingston, PA 18704-3422 | |
| Sandra M Turinski | Clinical Social Worker | 222 Wyoming Ave, Kingston, PA 18704-3503 | |
| Sharon A Laskowski | Clinical Social Worker | 230 Wyoming Ave, Kingston, PA 18704-3535 | |
| Find all physicians in zip 18704 | |||
| City | KINGSTON |
| Zip Code | 18704 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | KINGSTON + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Daniel J Dudrick.
| 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.