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General NPI Number Information
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NPI Number | 1720150360
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Entity Type | Organization
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Legal Business Name | BAYVIEW MEDICAL PRACTICE
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 510 CRANBERRY ST SUITE 2OO
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City | ERIE
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State | PA
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Zip | 16507-1075
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Country | US
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Telephone | 814-459-3141
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Fax | 814-459-4641
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Provider Business Mailing Address
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Address Line | 510 CRANBERRY ST SUITE 2OO
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City | ERIE
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State | PA
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Zip | 16507-1075
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Country | US
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Telephone | 814-459-3141
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Fax | 814-459-4641
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. PAMELA SUE MOREY
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Credential | D.O.
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Telephone | 814-459-3141
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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 | PA
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