Healthcare Provider Details
I. General information
NPI: 1922316314
Provider Name (Legal Business Name): SILVERCRESTMD,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/20/2010
Last Update Date: 09/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
231 BELMONT TPKE
WAYMART PA
18472-6033
US
IV. Provider business mailing address
231 BELMONT TPKE
WAYMART PA
18472-6033
US
V. Phone/Fax
- Phone: 570-488-7777
- Fax: 570-488-9808
- Phone: 570-488-7777
- Fax: 570-488-9808
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | MD063049L |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | MD063049L |
| License Number State | PA |
VIII. Authorized Official
Name: DR.
ALLEN
JAMES
OREHEK
Title or Position: MEDICAL DOCTOR
Credential: M.D.
Phone: 570-488-7777