Healthcare Provider Details

I. General information

NPI: 1104821057
Provider Name (Legal Business Name): WILLIAM J PARONISH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 08/04/2021
Certification Date: 08/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1106 BIGLER AVE SUITE #2
NORTHERN CAMBRIA PA
15714
US

IV. Provider business mailing address

PO BOX 776
NORTHERN CAMBRIA PA
15714-0776
US

V. Phone/Fax

Practice location:
  • Phone: 814-948-4560
  • Fax: 814-948-8436
Mailing address:
  • Phone: 814-948-4560
  • Fax: 814-948-8436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD029402E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: