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General NPI Number Information
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NPI Number | 1235171570
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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 | 06/12/2006
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Last Update Date | 03/11/2009
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Provider Practice Location Address
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Address Line | 1645 ROSTRAVER RD
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City | BELLE VERNON
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State | PA
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Zip | 15012-9655
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Country | US
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Telephone | 724-929-2260
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 18619
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City | PITTSBURGH
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State | PA
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Zip | 15236-0619
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Country | US
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Telephone | 724-929-2640
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Fax |
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Authorized Official
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Title or Position | 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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | PA
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