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General NPI Number Information
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NPI Number | 1346619145
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Entity Type | Organization
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Legal Business Name | THOMAS R MASTERS DO
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Dates
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Enumeration Date | 09/22/2015
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Last Update Date | 09/22/2015
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Provider Practice Location Address
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Address Line | 2828 STERRETTANIA RD
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City | ERIE
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State | PA
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Zip | 16506-3050
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Country | US
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Telephone | 814-833-9700
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Fax |
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Provider Business Mailing Address
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Address Line | 2828 STERRETTANIA RD
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City | ERIE
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State | PA
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Zip | 16506-3050
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | THOMAS R MASTERS
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Credential |
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Telephone | 814-835-5259
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS005118L
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License Number State | PA
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