Charlene M Dehaven (NPI# 1033229471, PAC ID# 9739135203) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is EMERGENCY MEDICINE.
| Nation Provider ID (NPI) | 1033229471 |
| PAC ID by PECOS | 9739135203 |
| Professional Enrollment ID | I20050328000815 |
| Full Name | Charlene M Dehaven |
| Organization Legal Name | BONNER GENERAL HOSPITAL, INC. |
| Address |
400 Schweitzer Plaza Dr Suite 1 Ponderay ID 83852-9819 |
| Phone Number | 2082630649 |
| Gender | F |
| Credential | MD |
| Medical School | UNIVERSITY OF KANSAS SCHOOL OF MEDICINE |
| Graduation Year | 1975 |
| Primary Specialty | EMERGENCY MEDICINE |
| Group Practice PAC ID | 4082690466 |
| Number of Group Practice Members | 37 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 131328 | BONNER GENERAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 400 Schweitzer Plaza Dr, Suite 1, Ponderay, ID 83852-9819 | 2082630649 | BONNER GENERAL HOSPITAL, INC. |
| 400 Schweitzer Plaza Dr, Ponderay, ID 83852-9819 | 2082630649 | BONNER GENERAL HOSPITAL, INC. |
| Organization Legal Name | BONNER GENERAL HOSPITAL, INC. |
| Physicians | 32 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Douglas A Cipriano | Orthopedic Surgery | Bonner General Hospital, Inc. | 606 N 3rd Ave, Suite 201, Sandpoint, ID 83864-1689 |
| Brian J Mcnamee | Diagnostic Radiology | Bonner General Hospital, Inc. | 423 N 3rd Ave, Suite 210, Sandpoint, ID 83864-1505 |
| Morgan A Morton | Obstetrics/gynecology | Bonner General Hospital, Inc. | 423 N 3rd Ave, Suite 210, Sandpoint, ID 83864-1505 |
| Natasha M Splaine | Nurse Practitioner | Bonner General Hospital, Inc. | 423 N 3rd Ave, Sandpoint, ID 83864-1505 |
| Bryan D Berkey | Diagnostic Radiology | Bonner General Hospital, Inc. | 423 N 3rd Ave, Sandpoint, ID 83864-1505 |
| Albert J Martinez | Diagnostic Radiology | Bonner General Hospital, Inc. | 423 N 3rd Ave, Suite 210, Sandpoint, ID 83864-1505 |
| Joseph A Wassif | Psychologist, Clinical | Bonner General Hospital, Inc. | 423 N 3rd Ave, Sandpoint, ID 83864-1505 |
| Amelia W Huntsberger | Obstetrics/gynecology | Bonner General Hospital, Inc. | 423 N 3rd Ave, Sandpoint, ID 83864-1505 |
| Randon Opp | Diagnostic Radiology | Bonner General Hospital, Inc. | 423 N 3rd Ave, Suite 210, Sandpoint, ID 83864-1505 |
| John M Faggard Iii | Orthopedic Surgery | Bonner General Hospital, Inc. | 606 N 3rd Ave, Suite 201, Sandpoint, ID 83864-1689 |
| Street Address |
400 SCHWEITZER PLAZA DR SUITE 1 |
| City | PONDERAY |
| State | ID |
| Zip | 83852-9819 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ryan F Webster | Chiropractic | 400 Schweitzer Plaza Dr, Suite 4, Ponderay, ID 83852-9819 | |
| James P Lathrop | Nurse Practitioner | Bonner General Hospital, Inc. | 400 Schweitzer Plaza Dr, Suite 1, Ponderay, ID 83852-9819 |
| Susan A Steiner | Nurse Practitioner | Bonner General Hospital, Inc. | 400 Schweitzer Plaza Dr, Suite 1, Ponderay, ID 83852-9819 |
| Kenneth R Conger | Family Practice | Bonner General Hospital, Inc. | 400 Schweitzer Plaza Dr, Suite 1, Ponderay, ID 83852-9819 |
| Paul G Rumore | Emergency Medicine | Bonner General Hospital, Inc. | 400 Schweitzer Plaza Dr, Suite 1, Ponderay, ID 83852-9819 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bruce W Demko | Certified Registered Nurse Anesthetist (crna) | 30544 Hwy 200 201, Ponderay, ID 83852-5005 | |
| Joan M Bloom | Family Medicine | Michael R Dibenedetto Md Pllc | 30544 Hwy 200, Suite 102, Ponderay, ID 83852-5005 |
| K Garrett Fischer | Physical Therapy | Kauai In-home Therapy LLC | 30544 Hwy 200, Ponderay, ID 83852-5005 |
| Travis L Taylor | Nurse Practitioner | Michael R Dibenedetto Md Pllc | 30544 Hwy 200, Suite 102, Ponderay, ID 83852-5005 |
| Lindsey M Ruppel | Family Medicine | Michael R Dibenedetto Md Pllc | 30544 Hwy 200, Suite 102, Ponderay, ID 83852-5005 |
| Michael R Di Benedetto | Orthopedic Surgery | Michael R Dibenedetto Md Pllc | 30544 Hwy 200, Suite 102, Ponderay, ID 83852-5005 |
| Michael D Schicker | Orthopedic Surgery | Michael R Dibenedetto Md Pllc | 30544 Hwy 200, Suite 102, Ponderay, ID 83852-5005 |
| Jonathan D Fisher | Podiatry | Michael R Dibenedetto Md Pllc | 30544 Hwy 200, Suite 102, Ponderay, ID 83852-5005 |
| Darwin L Hurst | Nurse Practitioner | Michael R Dibenedetto Md Pllc | 30544 Hwy 200, Suite 102, Ponderay, ID 83852-5005 |
| Jonathan Roy Gardunia | Physical Therapy | Kauai In-home Therapy LLC | 30544 Hwy 200, Ponderay, ID 83852-5005 |
| Find all physicians in zip 83852 | |||
| City | PONDERAY |
| Zip Code | 83852 |
| Specialty | EMERGENCY MEDICINE |
| City + Specialty | PONDERAY + EMERGENCY MEDICINE |
Please comment or provide details below to improve the information on Charlene M Dehaven.
| 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.