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NPI Code Detail

MEDICARE: PRIMARY CARE GROUP 4 INC

MEDICARE: PRIMARY CARE GROUP 4 INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1063646438
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRIMARY CARE GROUP 4 INC
Provider Business Mailing Address
First Line : 1907 LEBANON CHURCH RD
Second Line :
City : WEST MIFFLIN
State : PA
Zip : 15122-2432
Country : US
Telephone Number : 412-655-8515
Fax Number : 412-655-3288
Provider Business Practice Location Address
First Line : 1907 LEBANON CHURCH RD
Second Line :
City : WEST MIFFLIN
State : PA
Zip : 15122-2432
Country : US
Telephone Number : 412-655-8515
Fax Number : 412-655-3288
Authorized Official
Title or Position : MEDICAL PHYSICIAN
Name : PAUL G LINDER
Credential : M.D.
Telephone Number : 412-655-8515
Provider Enumeration Date : 05/13/2009
Last Update Date : 06/29/2009

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