MEDICARE: DIGESTIVE CARE CONSULTANTS PC

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
1	207RG0100X	Gastroenterology Physician	077567	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DB3734	OTHER		RR MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1912903287
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIGESTIVE CARE CONSULTANTS PC

Provider Business Mailing Address
First Line	:	585 RUGH STREET
Second Line	:	SUITE 202
City	:	GREENSBURG
State	:	PA
Zip	:	15601-5667
Country	:	US
Telephone Number	:	724-838-1534
Fax Number	:	724-838-1536

Provider Business Practice Location Address
First Line	:	8775 NORWIN AVENUE
Second Line	:
City	:	NORTH HUNTINGDON
State	:	PA
Zip	:	15642-2718
Country	:	US
Telephone Number	:	724-864-0503
Fax Number	:	724-864-0535

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BALU SHETTY
Credential	:	MD
Telephone Number	:	724-864-0503

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	11/03/2011

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Directions to “DIGESTIVE CARE CONSULTANTS PC ” Practice Location

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