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General NPI Number Information
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NPI Number | 1881651016
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Entity Type | Organization
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Legal Business Name | CENTRE MEDICAL AND SURGICAL ASSOCIATES, P.C.
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Dates
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Enumeration Date | 05/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 141 MEDICAL PARK LN
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City | BELLEFONTE
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State | PA
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Zip | 16823-9112
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Country | US
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Telephone | 814-355-3626
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Fax | 814-355-8479
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Provider Business Mailing Address
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Address Line | 141 MEDICAL PARK LN
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City | BELLEFONTE
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State | PA
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Zip | 16823-9112
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Country | US
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Telephone | 814-355-3626
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Fax | 814-355-8479
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Authorized Official
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Title or Position | COO/ADMINISTRATIVE DIRECTOR
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Name | JOHN MCQUEARY
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Credential |
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Telephone | 814-234-4753
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD019154E
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License Number State | PA
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