Healthcare Provider Details

I. General information

NPI: 1497815690
Provider Name (Legal Business Name): ALLEGHENY MEDICAL PRACTICE NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 05/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 FREEPORT RD
CREIGHTON PA
15030-1026
US

IV. Provider business mailing address

521 FREEPORT RD
CREIGHTON PA
15030-1026
US

V. Phone/Fax

Practice location:
  • Phone: 724-337-8383
  • Fax: 724-337-8055
Mailing address:
  • Phone: 724-337-8383
  • Fax: 724-337-8055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CINDY WALTEMIRE
Title or Position: MANAGED CARE SPECIALIST
Credential:
Phone: 412-330-5523