MEDICARE: ALLEGHENY CLINIC

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

General Provider Information

NPI Number	:	1942679790
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLEGHENY CLINIC

Provider Business Mailing Address
First Line	:	201 ERIE ST STE C
Second Line	:
City	:	GROVE CITY
State	:	PA
Zip	:	16127-1659
Country	:	US
Telephone Number	:	724-458-7005
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 ERIE ST STE C
Second Line	:
City	:	GROVE CITY
State	:	PA
Zip	:	16127-1659
Country	:	US
Telephone Number	:	724-458-7005
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	CINDY WALTEMIRE
Credential	:
Telephone Number	:	412-330-5523

Provider Enumeration Date	:	09/23/2015
Last Update Date	:	09/23/2015

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Directions to “ALLEGHENY CLINIC ” Practice Location

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