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NPI Code Detail

MEDICARE: CAMBRIA GASTROENTEROLOGY, INC.

MEDICARE: CAMBRIA GASTROENTEROLOGY, 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 PhysicianMD037398LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1467572826
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAMBRIA GASTROENTEROLOGY, INC.
Provider Business Mailing Address
First Line : 970 FRANKLIN ST
Second Line :
City : JOHNSTOWN
State : PA
Zip : 15905-4107
Country : US
Telephone Number : 814-535-1500
Fax Number : 814-536-5648
Provider Business Practice Location Address
First Line : 970 FRANKLIN ST
Second Line :
City : JOHNSTOWN
State : PA
Zip : 15905-4107
Country : US
Telephone Number : 814-535-1500
Fax Number : 814-536-5648
Authorized Official
Title or Position : OWNER
Name : DR. HIRA L. KOUL
Credential : M.D.
Telephone Number : 814-525-1500
Provider Enumeration Date : 03/30/2007
Last Update Date : 03/19/2009

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Directions to “CAMBRIA GASTROENTEROLOGY, INC. ” Practice Location

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