Active NPI 1336312131 Individual Practitioner Male Practitioner

Dr. Dusan Martin , MD

Surgery • Miramar, FL

Professional Overview & Biography Verified Profile Summary

Dr. Dusan Martin, MD is a registered healthcare professional specializing in Surgery in Miramar, FL. Practice services are available at 3601 SW 160TH AVE under active NPI credentials.

Frequently performed procedures and clinical services include subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least, removal of skin and tissue, 20.0 sq cm or less, removal of muscle and/or tissue, 20.0 sq cm or less. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

3601 Sw 160th Ave
Suite 250

Miramar, FL 330276308

Telephone 8778667123

Associated Practice Facility / Clinic

🏢 Vohra Wound Physicians Of Fl, Llc Facility NPI 1942506647

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Miramar, FL

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 23.5 Yrs

State Avg: 26.3 Yrs

Regional Practice Density

39 Specialists

Practicing in Miramar, FL (2030 Statewide)

Telehealth Adoption Rate

17.9% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

57.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2023)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	485	183	$176.99	$87.18
11042 Removal of skin and tissue, 20.0 sq cm or less	466	114	$340.40	$123.43
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	392	103	$582.18	$278.44
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	276	156	$253.56	$123.76
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	185	146	$94.70	$45.76
17250 Application of chemical to stop tissue regrowth in wound	177	61	$236.02	$76.23
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	134	86	$176.87	$87.37
11042 Removal of skin and tissue, 20.0 sq cm or less	116	51	$340.35	$57.02
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	108	46	$582.10	$186.94
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	77	77	$313.32	$155.64
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	65	53	$253.29	$123.94
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	64	64	$313.42	$155.22
97597 Removal of tissue from wound, 20.0 sq cm or less	62	20	$244.00	$122.01
17250 Application of chemical to stop tissue regrowth in wound	59	23	$235.92	$29.24
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	57	55	$94.72	$45.92
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	51	20	$181.37	$90.30
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	47	47	$189.48	$94.12
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	38	38	$189.48	$93.84
11044 Removal of bone, 20.0 sq cm or less	26	11	$764.82	$382.03
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	25	20	$362.88	$178.48

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
11042 Removal of skin and tissue, 20.0 sq cm or less	452	98	$339.66	$135.83
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	347	114	$164.76	$82.16
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	342	93	$600.90	$292.46
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	238	90	$600.90	$193.88
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	215	129	$215.06	$107.15
11042 Removal of skin and tissue, 20.0 sq cm or less	192	82	$339.66	$53.66
17250 Application of chemical to stop tissue regrowth in wound	175	62	$239.76	$82.36
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	144	39	$193.60	$73.35
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	142	121	$103.86	$51.50
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	131	33	$193.60	$96.86
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	117	83	$164.76	$82.04
17250 Application of chemical to stop tissue regrowth in wound	104	44	$239.76	$32.37
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	102	76	$215.06	$107.18
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	93	89	$103.86	$51.50
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	91	21	$107.87	$53.36
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	67	66	$211.56	$103.76
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	66	66	$304.74	$150.43
11044 Removal of bone, 20.0 sq cm or less	46	13	$799.78	$399.88
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	38	32	$318.44	$157.34
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	37	37	$211.56	$105.00
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	36	36	$304.74	$150.98
99306 Initial nursing facility visit, typically 45 minutes per day	33	33	$392.04	$194.22
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	25	12	$106.70	$34.27
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	16	14	$318.44	$157.15
99306 Initial nursing facility visit, typically 45 minutes per day	16	16	$392.04	$194.26

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
11042 Removal of skin and tissue, 20.0 sq cm or less	558	108	$339.78	$130.70
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	470	101	$601.36	$292.89
17250 Application of chemical to stop tissue regrowth in wound	376	72	$240.05	$72.33
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	340	145	$164.86	$82.95
11042 Removal of skin and tissue, 20.0 sq cm or less	329	120	$340.06	$55.65
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	317	118	$601.41	$197.49
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	249	146	$215.21	$108.22
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	188	114	$164.89	$82.63
17250 Application of chemical to stop tissue regrowth in wound	173	64	$239.92	$28.03
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	171	48	$193.95	$74.35
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	151	124	$103.86	$52.28
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	129	18	$106.70	$53.82
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	128	30	$193.60	$97.68
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	128	92	$215.49	$108.18
11044 Removal of bone, 20.0 sq cm or less	88	12	$799.78	$403.40
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	82	82	$211.76	$106.39
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	79	77	$103.97	$52.23
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	60	60	$305.11	$153.27
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	48	19	$106.70	$34.81
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	40	36	$318.44	$160.26
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	35	35	$304.74	$153.41
99306 Initial nursing facility visit, typically 45 minutes per day	34	34	$392.04	$197.19
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	19	17	$318.44	$160.13
99306 Initial nursing facility visit, typically 45 minutes per day	17	17	$392.04	$197.34
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	14	14	$212.73	$106.50

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
11042 Removal of skin and tissue, 20.0 sq cm or less	470	105	$324.06	$117.97
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	411	98	$586.56	$290.04
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	356	159	$164.37	$82.26
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	343	111	$586.45	$193.53
17250 Application of chemical to stop tissue regrowth in wound	325	79	$222.81	$76.28
11042 Removal of skin and tissue, 20.0 sq cm or less	325	102	$324.00	$52.74
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	323	159	$216.47	$107.45
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	278	155	$164.29	$81.66
17250 Application of chemical to stop tissue regrowth in wound	154	59	$222.77	$32.25
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	152	115	$216.48	$107.37
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	145	115	$104.19	$52.15
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	123	112	$104.20	$51.94
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	120	37	$190.02	$73.05
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	92	92	$304.27	$151.71
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	88	20	$190.05	$95.64
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	63	63	$213.86	$107.04
99306 Initial nursing facility visit, typically 45 minutes per day	57	57	$394.20	$196.18
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	48	16	$106.14	$34.52
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	35	14	$106.14	$53.38
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	21	21	$214.33	$107.14
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	20	20	$304.10	$152.11
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	19	18	$317.92	$158.94
99306 Initial nursing facility visit, typically 45 minutes per day	11	11	$393.52	$197.82

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	727	215	$161.10	$79.82
17250 Application of chemical to stop tissue regrowth in wound	518	123	$210.80	$84.61
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	468	216	$213.92	$106.29
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	446	203	$161.10	$79.60
11042 Removal of skin and tissue, 20.0 sq cm or less	441	85	$309.60	$118.54
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	402	90	$565.36	$280.67
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	367	113	$565.36	$189.08
11042 Removal of skin and tissue, 20.0 sq cm or less	335	102	$309.60	$58.19
17250 Application of chemical to stop tissue regrowth in wound	238	73	$210.80	$34.95
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	235	187	$102.68	$50.87
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	213	146	$213.92	$106.09
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	143	138	$102.68	$50.49
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	111	41	$181.74	$69.71
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	110	110	$302.98	$149.51
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	79	79	$210.16	$103.95
99306 Initial nursing facility visit, typically 45 minutes per day	78	78	$386.50	$191.73
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	59	23	$181.74	$89.95
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	41	41	$302.98	$150.30
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	30	11	$102.04	$32.74
99306 Initial nursing facility visit, typically 45 minutes per day	28	28	$386.50	$191.96
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	20	20	$210.16	$104.06
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	14	13	$315.96	$157.13
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	12	12	$315.96	$156.84

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	1,022	208	$162.88	$79.44
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	520	209	$214.60	$105.11
17250 Application of chemical to stop tissue regrowth in wound	435	113	$208.62	$90.60
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	385	156	$162.88	$79.31
11042 Removal of skin and tissue, 20.0 sq cm or less	336	75	$298.52	$117.80
11042 Removal of skin and tissue, 20.0 sq cm or less	293	84	$298.52	$58.85
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	277	79	$560.62	$186.12
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	268	63	$560.62	$274.81
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	267	183	$104.52	$51.00
17250 Application of chemical to stop tissue regrowth in wound	192	72	$208.62	$39.07
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	162	104	$214.60	$104.92
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	139	105	$104.52	$50.77
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	102	32	$181.54	$68.31
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	81	20	$181.54	$88.36
99306 Initial nursing facility visit, typically 45 minutes per day	80	80	$387.80	$189.53
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	79	79	$303.72	$148.45
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	67	20	$101.95	$32.08
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	47	12	$101.95	$49.95
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	42	42	$303.72	$148.70
99306 Initial nursing facility visit, typically 45 minutes per day	27	27	$387.80	$189.64
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	23	23	$212.72	$103.85
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	16	16	$212.72	$104.05
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	14	13	$318.34	$155.56
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	13	13	$318.34	$155.64

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	1,139	230	$154.17	$76.41
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	531	194	$154.79	$76.46
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	475	204	$204.06	$101.13
17250 Application of chemical to stop tissue regrowth in wound	360	104	$192.24	$89.13
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	357	205	$100.71	$49.04
11042 Removal of skin and tissue, 20.0 sq cm or less	346	99	$277.17	$113.53
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	265	82	$515.72	$257.02
11042 Removal of skin and tissue, 20.0 sq cm or less	252	83	$270.18	$59.97
11043 Removal of muscle and/or tissue, 20.0 sq cm or less	242	84	$506.83	$180.51
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	231	163	$101.75	$49.23
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	185	121	$201.82	$100.56
17250 Application of chemical to stop tissue regrowth in wound	134	54	$197.43	$40.22
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	104	104	$291.20	$143.35
99306 Initial nursing facility visit, typically 45 minutes per day	89	89	$367.59	$181.11
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	65	21	$165.39	$66.47
11046 Removal of muscle and/or tissue, each additional 20.0 sq cm or less	51	16	$160.48	$85.59
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	38	38	$199.03	$100.75
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	37	12	$91.87	$47.14
11045 Removal of skin and tissue, each additional 20.0 sq cm or less	33	12	$83.56	$30.42
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	28	28	$297.11	$143.43
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	20	20	$294.21	$150.17
99304 Initial nursing facility care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	19	19	$206.99	$100.77
99306 Initial nursing facility visit, typically 45 minutes per day	18	18	$375.95	$183.21
99310 Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	17	15	$307.93	$150.49

Medical Specialties & State Licenses

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License NY 265530

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Family Medicine

NUCC Taxonomy Code: 207Q00000X

State License NY 265530-1

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners

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Family Medicine

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Doctor of Medicine (M.D.)

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Family Medicine

NPI 1003085390

Doctor of Medicine (M.D.)

Dr. Suryanarayan Jairaj , MD

Family Medicine

NPI 1003808734

Doctor of Medicine (M.D.)

Dr. Gustavo Camarano , MD

Internal Medicine - Cardiovascular Disease

NPI 1003860115

Doctor of Medicine (M.D.)

Dr. Arnold Fikkert , DO

Surgery

NPI 1023050754

Doctor of Osteopathic Medicine (D.O.)

Dr. Teresa Elliott , MD

Family Medicine

NPI 1023078870

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active August 28, 2012

NPI status registered as active in NPPES database

📍

Updated Practice Location August 28, 2012

Registered at 3601 SW 160TH AVE, SUITE 250, MIRAMAR, FL 330276308 (Tel: 8778667123)

📍

Updated Business Mailing Address August 28, 2012

Registered at 2201 HEMPSTEAD TPKE, NASSAU UNIVERSITY MEDICAL CENTER, EAST MEADOW, NY 115541859 (Tel: 5165725207)

👤

Provider Name / Credentials Updated August 28, 2012

Recorded as DUSAN MARTIN, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) August 28, 2012

Family Medicine (License #265530-1 in NY)

🟢

Initial NPI Registration & Enumeration April 12, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1336312131

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: April 12, 2008

Last Update: June 04, 2019

Sole Proprietor: No

Update or Correct Profile

Mailing Address

2201 Hempstead Tpke, Nassau University Medical Center

East Meadow, NY 115541859

Phone: 5165725207

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.