Abutaleb Ahsan Ejaz (NPI# 1700827136, PAC ID# 2163415092) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NEPHROLOGY.
| Nation Provider ID (NPI) | 1700827136 |
| PAC ID by PECOS | 2163415092 |
| Professional Enrollment ID | I20180914002423 |
| Full Name | Abutaleb Ahsan Ejaz |
| Organization Legal Name | CENTRA MEDICAL GROUP LLC |
| Address |
935 S Main St Farmville VA 23901-2211 |
| Phone Number | 4343155340 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1987 |
| Primary Specialty | NEPHROLOGY |
| Secondary Specialties | INTERNAL MEDICINE |
| Group Practice PAC ID | 4789606088 |
| Number of Group Practice Members | 583 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490090 | CENTRA SOUTHSIDE COMMUNITY HOSPITAL, INC |
| 490021 | CENTRA |
| Address | Phone | Organization |
|---|---|---|
| 935 S Main St, Farmville, VA 23901-2211 | 4343155340 | CENTRA MEDICAL GROUP LLC |
| Organization Legal Name | CENTRA MEDICAL GROUP LLC |
| Physicians | 561 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sebastian J Ksionski | Family Medicine | Centra Medical Group LLC | 935 S Main St, Farmville, VA 23901-2211 |
| Weijuan M Li | Interventional Cardiology | Centra Medical Group LLC | 1039 Mayberry Crossing Dr, Suite C, Moneta, VA 24121-6414 |
| Marie Andrea Lopez | Physician Assistant | Centra Medical Group LLC | 1911 Thomson Dr, Lynchburg, VA 24501-1008 |
| Tahmina H Brady | Family Medicine | Centra Medical Group LLC | 16890 Forest Rd, Forest, VA 24551-4059 |
| Sharon P Hawout | Certified Nurse Midwife (cnm) | Centra Medical Group LLC | 291 Mcbride Ln, Gretna, VA 24557-2773 |
| Jacqueline Perdue | Physician Assistant | Centra Medical Group LLC | 4830 Rucker Rd, Moneta, VA 24121-5281 |
| Jordan J Synkowski | Neurosurgery | Centra Medical Group LLC | 2138 Langhorne Rd, Lynchburg, VA 24501-1400 |
| Oluloniyin E Peters | Physical Medicine and Rehabilitation | Centra Medical Group LLC | 1330 Oak Ln, Lynchburg, VA 24503-2513 |
| John B Blalock Jr. | General Surgery | Centra Medical Group LLC | 1906 Thomson Dr, Lynchburg, VA 24501-1009 |
| Hope A Alexander | Nurse Practitioner | Centra Medical Group LLC | 412 Namozine St, Burkeville, VA 23922-3184 |
| Street Address |
935 S MAIN ST |
| City | FARMVILLE |
| State | VA |
| Zip | 23901-2211 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sebastian J Ksionski | Family Medicine | Centra Medical Group LLC | 935 S Main St, Farmville, VA 23901-2211 |
| Charles H Brooks | Nephrology | Centra Medical Group LLC | 935 S Main St, Farmville, VA 23901-2211 |
| John A Kona | Orthopedic Surgery | Centra Medical Group LLC | 935 S Main St, Farmville, VA 23901-2211 |
| Alexandra Marie March | Nurse Practitioner | Centra Medical Group LLC | 935 S Main St, Farmville, VA 23901-2211 |
| Jennifer G Jones | Nurse Practitioner | Centra Medical Group LLC | 935 S Main St, Farmville, VA 23901-2211 |
| Dion G Tomer | Nurse Practitioner | Centra Medical Group LLC | 935 S Main St, Farmville, VA 23901-2211 |
| Parker C Schmidt | Family Medicine | Centra Medical Group LLC | 935 S Main St, Farmville, VA 23901-2211 |
| William C Andrews Jr. | Orthopedic Surgery | Centra Medical Group LLC | 935 S Main St, Farmville, VA 23901-2211 |
| Carrie W Cobb | Dermatology | Dermatologic and Mohs Surgery Consultants LLC | 935 S Main St, Farmville, VA 23901-2211 |
| Supriya Mannepalli | Family Medicine | Centra Medical Group LLC | 935 S Main St, Farmville, VA 23901-2211 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Andrea Blaisdell | Physical Therapy | Centra Outpatient Rehabilitation Services LLC | 935 Main St, Farmville, VA 23901 |
| Rhian Mccann | Physical Therapy | Centra Outpatient Rehabilitation Services LLC | 935 Main St, Farmville, VA 23901 |
| Jonathan Lundberg | Physical Therapy | Centra Outpatient Rehabilitation Services LLC | 935 Main St, Farmville, VA 23901 |
| Jennifer Mohan | Speech Language Pathologist | Centra Outpatient Rehabilitation Services LLC | 935 Main St, Farmville, VA 23901 |
| Sarah Parker | Speech Language Pathologist | Centra Outpatient Rehabilitation Services LLC | 935 Main St, Farmville, VA 23901 |
| Shashidharan B Ayer | Nephrology | 1801 E 3rd St, Farmville, VA 23901-0245 | |
| Ripon W La Roche | Ophthalmology | Southside Eye Center PC | 1511 W 3rd St, Farmville, VA 23901-0506 |
| St Claire R La Roche | Optometry | Southside Eye Center PC | 1511 W 3rd St, Farmville, VA 23901-0506 |
| Ripon W La Roche Iii | Optometry | Southside Eye Center PC | 1511 W 3rd St, Farmville, VA 23901-0506 |
| Edwina C Wilson | Family Medicine | Central Virginia Health Services Inc | 833 Buffalo St, Farmville, VA 23901-1111 |
| Find all physicians in zip 23901 | |||
| City | FARMVILLE |
| Zip Code | 23901 |
| Specialty | NEPHROLOGY |
| City + Specialty | FARMVILLE + NEPHROLOGY |
Please comment or provide details below to improve the information on Abutaleb Ahsan Ejaz.
| 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.