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General NPI Number Information
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NPI Number | 1679522478
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Entity Type | Organization
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Legal Business Name | HERMITAGE ORTHOPEDICS AND SPORTS MEDICINE, P.C.
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 12/05/2012
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Provider Practice Location Address
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Address Line | 1005 CAMPUS CIR
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City | HERMITAGE
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State | PA
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Zip | 16148-7901
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Country | US
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Telephone | 724-346-2677
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Fax | 724-346-2825
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Provider Business Mailing Address
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Address Line | 1005 CAMPUS CIR
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City | HERMITAGE
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State | PA
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Zip | 16148-7901
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Country | US
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Telephone | 724-346-2677
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Fax | 724-346-2825
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID A TONNIES
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Credential | MD
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Telephone | 724-346-2677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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