Healthcare Provider Details

I. General information

NPI: 1770604076
Provider Name (Legal Business Name): DANIEL MEDIC AND ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 08/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8791 BARNES LAKE ROAD SUITE 101
NORTH HUNTINGDON PA
15642
US

IV. Provider business mailing address

8791 BARNES LAKE ROAD SUITE 101
NORTH HUNTINGDON PA
15642
US

V. Phone/Fax

Practice location:
  • Phone: 724-864-9400
  • Fax: 724-864-8044
Mailing address:
  • Phone: 724-864-9400
  • Fax: 724-864-8044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS005950L
License Number StatePA

VIII. Authorized Official

Name: DANIEL MEDIC
Title or Position: PRESIDENT
Credential: D.O.
Phone: 724-864-9400