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General NPI Number Information
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NPI Number | 1083856165
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Entity Type | Organization
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Legal Business Name | PRIME MEDICAL GROUP
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Dates
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Enumeration Date | 04/03/2009
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Last Update Date | 04/03/2009
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Provider Practice Location Address
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Address Line | 180 FORT COUCH RD SUITE 275
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City | PITTSBURGH
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State | PA
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Zip | 15241-1041
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Country | US
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Telephone | 412-831-2288
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Fax | 412-831-2679
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Provider Business Mailing Address
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Address Line | 515 BROAD AVE
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City | BELLE VERNON
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State | PA
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Zip | 15012-1405
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Country | US
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Telephone | 724-929-4930
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Fax | 724-929-4308
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | DARLA SETHMAN
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Credential |
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Telephone | 724-929-2640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD037195E
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD037112E
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License Number State | PA
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