Healthcare Provider Details

I. General information

NPI: 1740231091
Provider Name (Legal Business Name): GEORGE R CHERIAN M.D., P.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 06/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

803 W MAHONING ST
PUNXSUTAWNEY PA
15767-1309
US

IV. Provider business mailing address

803 W MAHONING ST
PUNXSUTAWNEY PA
15767-1309
US

V. Phone/Fax

Practice location:
  • Phone: 814-938-0123
  • Fax: 814-938-2344
Mailing address:
  • Phone: 814-938-0123
  • Fax: 814-938-2344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD037172L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: