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General NPI Number Information
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NPI Number | 1548311681
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Entity Type | Organization
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Legal Business Name | FD MEDICAL MANAGEMENT, INC.
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9218 ROUTE 119 SOUTH
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City | BLACK LICK
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State | PA
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Zip | 15716
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Country | US
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Telephone | 724-248-9011
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Fax | 724-248-9020
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Provider Business Mailing Address
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Address Line | PO BOX 478
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City | BLACK LICK
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State | PA
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Zip | 15716-0478
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Country | US
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Telephone | 724-248-9011
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Fax | 724-248-9020
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES S LAPCEVIC
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Credential | D.O.
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Telephone | 724-248-9011
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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 |
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License Number State |
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