Healthcare Provider Details

I. General information

NPI: 1447210992
Provider Name (Legal Business Name): CHARLES M AMADEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 02/27/2020
Certification Date: 02/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 SOUTH ST
GREENSBURG PA
15601-2775
US

IV. Provider business mailing address

134 INDUSTRIAL PARK RD STE 1500
GREENSBURG PA
15601-8153
US

V. Phone/Fax

Practice location:
  • Phone: 724-830-8527
  • Fax: 724-850-3145
Mailing address:
  • Phone: 724-850-6933
  • Fax: 724-522-4002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD029476E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: