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General NPI Number Information
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NPI Number | 1902962525
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Entity Type | Organization
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Legal Business Name | TRI-STATE PULMONARY MEDICINE, LTD.
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 01/28/2008
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Provider Practice Location Address
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Address Line | 1201 3RD ST
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City | BEAVER
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State | PA
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Zip | 15009-2530
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Country | US
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Telephone | 724-728-5995
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Fax | 724-728-5518
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Provider Business Mailing Address
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Address Line | 1201 3RD ST
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City | BEAVER
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State | PA
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Zip | 15009-2530
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Country | US
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Telephone | 724-728-5995
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Fax | 724-728-5518
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Authorized Official
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Title or Position | PRESIDENT
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Name | PATRICK STURM
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Credential | M.D.
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Telephone | 724-728-5995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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