MEDICARE: FAMILY PRACTICE MEDICAL CENTER, 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
1	207Q00000X	Family Medicine Physician

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	:	1942242631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY PRACTICE MEDICAL CENTER, INC

Provider Business Mailing Address
First Line	:	907 WASHINGTON AVE
Second Line	:
City	:	CARNEGIE
State	:	PA
Zip	:	15106
Country	:	US
Telephone Number	:	724-941-2323
Fax Number	:	724-941-2325

Provider Business Practice Location Address
First Line	:	907 WASHINGTON AVE
Second Line	:
City	:	CARNEGIE
State	:	PA
Zip	:	15106-3215
Country	:	US
Telephone Number	:	724-941-2323
Fax Number	:	724-941-2325

Authorized Official
Title or Position	:	PRESIDENT
Name	:	WILL.IAM P CATENA
Credential	:	MD
Telephone Number	:	724-941-2323

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	05/26/2010

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