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General NPI Number Information
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NPI Number | 1306240692
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Entity Type | Organization
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Legal Business Name | INTERNAL MEDICINE DIAGNOSTICS INC
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Dates
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Enumeration Date | 10/15/2014
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Last Update Date | 10/15/2014
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Provider Practice Location Address
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Address Line | 881 HILLS PLZ SUITE 530
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City | EBENSBURG
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State | PA
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Zip | 15931-4213
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Country | US
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Telephone | 814-419-8084
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Fax | 814-419-8053
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Provider Business Mailing Address
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Address Line | 881 HILLS PLZ SUITE 530
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City | EBENSBURG
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State | PA
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Zip | 15931-4213
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Country | US
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Telephone | 814-419-8084
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Fax | 814-419-8053
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. MOLLY B TROSTLE
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Credential |
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Telephone | 814-419-8084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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