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General NPI Number Information
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NPI Number | 1770527004
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Entity Type | Organization
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Legal Business Name | CRAGO FAMILY MEDICINE P.C.
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Dates
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Enumeration Date | 06/16/2006
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Last Update Date | 09/13/2016
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Provider Practice Location Address
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Address Line | 3150 HIGHLAND RD SUITE 102
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City | HERMITAGE
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State | PA
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Zip | 16148-4516
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Country | US
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Telephone | 724-347-6356
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Fax | 724-347-3161
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Provider Business Mailing Address
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Address Line | 3150 HIGHLAND RD SUITE 102
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City | HERMITAGE
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State | PA
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Zip | 16148-4516
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Country | US
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Telephone | 724-347-6356
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Fax | 724-347-3161
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Authorized Official
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Title or Position | OWNER
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Name | DR. MATTHEW DAVID CRAGO
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Credential | DO
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Telephone | 724-347-6356
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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 | OS-010124-L
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License Number State | PA
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