MEDICARE: ALEXANDER G PATERSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD018560E	PA

General Provider Information

NPI Number	:	1053317412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDER G PATERSON MD

Provider Business Mailing Address
First Line	:	1086 FRANKLIN ST
Second Line	:
City	:	JOHNSTOWN
State	:	PA
Zip	:	15905-4305
Country	:	US
Telephone Number	:	814-410-8300
Fax Number	:	814-410-8331

Provider Business Practice Location Address
First Line	:	1611 PITT STREET
Second Line	:	ROUTE 30
City	:	JENNERSTOWN
State	:	PA
Zip	:	15547
Country	:	US
Telephone Number	:	814-629-5647
Fax Number	:	814-629-5273

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	05/04/2011

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