MEDICARE: MARK PATRICK SERALY M.D.

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	207N00000X	Dermatology Physician	MD052489L	PA
2	207NS0135X	Procedural Dermatology Physician	MD052489L	PA

General Provider Information

NPI Number	:	1912907452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK PATRICK SERALY M.D.

Provider Business Mailing Address
First Line	:	222 E MCMURRAY RD
Second Line	:
City	:	MC MURRAY
State	:	PA
Zip	:	15317-2948
Country	:	US
Telephone Number	:	724-969-2500
Fax Number	:	724-969-2510

Provider Business Practice Location Address
First Line	:	222 E MCMURRAY RD
Second Line	:
City	:	MC MURRAY
State	:	PA
Zip	:	15317-2948
Country	:	US
Telephone Number	:	724-969-2500
Fax Number	:	724-969-2510

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2005
Last Update Date	:	07/12/2024

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