Mark A Dettelbach (NPI# 1467425546, PAC ID# 9638135254) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OTOLARYNGOLOGY.
| Nation Provider ID (NPI) | 1467425546 |
| PAC ID by PECOS | 9638135254 |
| Professional Enrollment ID | I20120202000739 |
| Full Name | Mark A Dettelbach |
| Organization Legal Name | CENTERS FOR ADVANCED ENT CARE LLC |
| Address |
1145 19th St Nw Suite 402 Washington DC 20036-3716 |
| Phone Number | 3016528847 |
| Gender | M |
| Medical School | YALE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1990 |
| Primary Specialty | OTOLARYNGOLOGY |
| Group Practice PAC ID | 1658647359 |
| Number of Group Practice Members | 115 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 5454 Wisconsin Ave, Suite 1535, Chevy Chase, MD 20815-6922 | 3016528847 | CENTERS FOR ADVANCED ENT CARE LLC |
| 1145 19th St Nw, Suite 402, Washington, DC 20036-3716 | 3016528847 | CENTERS FOR ADVANCED ENT CARE LLC |
| Organization Legal Name | CENTERS FOR ADVANCED ENT CARE LLC |
| Physicians | 112 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Megan R Murphy | Qualified Audiologist | Centers for Advanced Ent Care LLC | 2070 Old Bridge Rd, Suite 103, Lake Ridge, VA 22192-2495 |
| Roraine Bunag | Qualified Audiologist | Centers for Advanced Ent Care LLC | 4000 Mitchellville Rd, Suite A414, Bowie, MD 20716-3142 |
| Manan Udayan Shah | Otolaryngology | Centers for Advanced Ent Care LLC | 11705 Berry Rd, Suite 103, Waldorf, MD 20603-5933 |
| Brittany Bailey Tuscany | Qualified Audiologist | Centers for Advanced Ent Care LLC | 2002 Medical Pkwy, Suite 230, Annapolis, MD 21401-3282 |
| Jacquelyn C Jackson | Qualified Audiologist | Centers for Advanced Ent Care LLC | 818 W Diamond Ave, Suite 120, Gaithersburg, MD 20878-1450 |
| Angela Marie Redpath | Physician Assistant | Centers for Advanced Ent Care LLC | 120 Sister Pierre Dr, Suite 202, Towson, MD 21204-7525 |
| Virginia L Wise | Qualified Audiologist | Centers for Advanced Ent Care LLC | 163 Thomas Johnson Dr, Suite H, Frederick, MD 21702-4673 |
| David James Hoyt | Otolaryngology | Centers for Advanced Ent Care LLC | 4 A N Ave, Suite 202, Bel Air, MD 21014-2316 |
| Annette M Pham | Otolaryngology | Centers for Advanced Ent Care LLC | 15001 Shady Grove Rd, Suite 100, Rockville, MD 20850-6354 |
| Cynthia A Fannon | Qualified Audiologist | Centers for Advanced Ent Care LLC | 6535 N Charles St, Suite 250, Baltimore, MD 21204-5829 |
| Street Address |
1145 19TH ST NW SUITE 402 |
| City | WASHINGTON |
| State | DC |
| Zip | 20036-3716 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tolulope A Agunbiade | Cardiovascular Disease (cardiology) | Medstar Medical Group II LLC | 1145 19th St Nw, 311 Mmg At 19th Street Nw, Washington, DC 20036-3735 |
| Lauren M Craig | Dermatology | Integrated Dermatology of 19th Street LLC | 1145 19th St Nw, Suite 301, Washington, DC 20036-3718 |
| Roshiel D Tiu | Obstetrics/gynecology | Medstar Medical Group II LLC | 1145 19th St Nw, 311 Mmg At 19th Street Nw, Washington, DC 20036-3735 |
| Justin A Mullner | Family Medicine | Medstar Medical Group II LLC | 1145 19th St Nw, 311 Mmg At 19th Street Nw, Washington, DC 20036-3735 |
| Emerson L Coronel | Internal Medicine | Medstar Medical Group II LLC | 1145 19th St Nw, 311 Mmg At 19th Street Nw, Washington, DC 20036-3735 |
| Michael Gillespie | General Surgery | Medstar Medical Group II LLC | 1145 19th St Nw, 311 Mmg At 19th Street Nw, Washington, DC 20036-3735 |
| Christopher J Mays | Internal Medicine | Medstar Medical Group II LLC | 1145 19th St Nw, 311 Mmg At 19th Street Nw, Washington, DC 20036-3735 |
| Emmanuella Maria Eastman | Podiatry | Foot and Ankle Specialists of The Mid Atlantic LLC | 1145 19th St Nw, Suite 605, Washington, DC 20036-3731 |
| Luther Lorenzo Ampey Iii | Radiation Oncology | Medstar Medical Group II LLC | 1145 19th St Nw, 311 Mmg At 19th Street Nw, Washington, DC 20036-3735 |
| Behzad Doratotaj | Hematology/oncology | Medstar Medical Group II LLC | 1145 19th St Nw, 311 Mmg At 19th Street Nw, Washington, DC 20036-3735 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Aisha R Riley | Nurse Practitioner | 2001 Massachusetts Nwave, Washington, DC 20036-1011 | |
| Nyeesha N Thompson | Nurse Practitioner | Eric C. Marshall Md PC | 6 Dupont Cir Nw, Minuteclinic Diagnostic of Dc, Washington, DC 20036-1108 |
| Tara Devineni | Clinical Social Worker | Tara Devineni, Licsw, LLC | 1555 Connecticut Ave Nw, Washington, DC 20036-1111 |
| Eric C Bergman | Psychiatry | 1555 Connecticut Ave Nw, Suite 300w, Washington, DC 20036-1125 | |
| Carrie E Renfro | Clinical Social Worker | Family Matters of Greater Washington | 1509 16th St Nw, Washington, DC 20036-1461 |
| Jorge A Membreno | Clinical Social Worker | Family Matters of Greater Washington | 1509 16th St Nw, Washington, DC 20036-1461 |
| Trinaty N Fofana | Clinical Social Worker | Family Matters of Greater Washington | 1509 16th St Nw, Washington, DC 20036-1461 |
| Mary R Cuevas | Clinical Social Worker | Family Matters of Greater Washington | 1509 16th St Nw, Washington, DC 20036-1461 |
| Cheryl Tran | Optometry | Miller Eyecare Annapolis Dc, LLC | 1330 Connecticut Nwave, Washington, DC 20036-1704 |
| Chales Gamboa | Optometry | Miller Eyecare Annapolis Dc, LLC | 1330 Connecticut Nwave, Washington, DC 20036-1704 |
| Find all physicians in zip 20036 | |||
| City | WASHINGTON |
| Zip Code | 20036 |
| Specialty | OTOLARYNGOLOGY |
| City + Specialty | WASHINGTON + OTOLARYNGOLOGY |
Please comment or provide details below to improve the information on Mark A Dettelbach.
| 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.