Healthcare Provider Details

I. General information

NPI: 1598043416
Provider Name (Legal Business Name): LAURA MEJIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2011
Last Update Date: 06/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

532 W PITTSBURGH ST INTERNAL MEDICINE DEPARTMENT
GREENSBURG PA
15601-2239
US

IV. Provider business mailing address

520 JEFFERSON AVE SUITE 400
JEANNETTE PA
15644-2538
US

V. Phone/Fax

Practice location:
  • Phone: 724-832-4000
  • Fax:
Mailing address:
  • Phone: 724-527-8060
  • Fax: 724-527-4002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD446859
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMT195381
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD446859
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: