Healthcare Provider Details

I. General information

NPI: 1033115464
Provider Name (Legal Business Name): PHILIP H SYMES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 10/29/2020
Certification Date: 10/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2508 MYRTLE ST STE 200
ERIE PA
16502-2700
US

IV. Provider business mailing address

247 MOREWOOD AVE
PITTSBURGH PA
15213-1861
US

V. Phone/Fax

Practice location:
  • Phone: 814-452-7822
  • Fax: 814-452-7824
Mailing address:
  • Phone: 412-622-0290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberMD047660
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: