Dwaraki Bai Penugonda Md Pc

LBN: Dwaraki Bai Penugonda Md Pc
Dwaraki Bai Penugonda Md Pc is an health care organization with primary practice located at 166 Hanover St , Wilkes Barre PA 18702-3549. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Dwaraki Bai Penugonda Md Pc can be contacted via phone (570) 823-8184, or through Penugonda, Dwaraki Bai via phone (570) 823-8184.

Contact Information

Primary practice address
166 Hanover St Wilkes Barre PA 18702-3549
Phone: (570) 823-8184
Fax: (570) 823-6460
Website:
Map and Directions
Authorized official contact:
Name: Penugonda, Dwaraki Bai Doctor of Medicine (MD)
Phone: (570) 823-8184

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MD035084Y Pennsylvania

Profile Details

NPI number 1588866792
LBN Legal business name Dwaraki Bai Penugonda Md Pc
DBA Doing business as
Authorized official Penugonda, Dwaraki Bai Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 1st, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588866792 NPPES
Pennsylvania MEDICAID 0006538020001

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