| Bayfront Digestive Disease | |
|
100 Peach St Suite 200 Erie PA 16507-1411 | |
| (814) 456-7733 | |
| (814) 456-7213 |
| Full Name | Bayfront Digestive Disease |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 100 Peach St, Erie, Pennsylvania |
| Authorized Official Name and Position | Tina M Casillo (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 8144567733 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bayfront Digestive Disease 100 Peach St Suite 200 Erie PA 16507-1411 Ph: (814) 456-7733 | Bayfront Digestive Disease 100 Peach St Suite 200 Erie PA 16507-1411 Ph: (814) 456-7733 |
| NPI Number | 1295772861 |
|---|---|
| Provider Enumeration Date | 06/01/2006 |
| Last Update Date | 11/13/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295772861 | NPI | - | NPPES |
| 0010182600013 | Medicaid | PA | |
| B185348 | Other | PA | HIGHMARK BLUE SHIELD GRP |
| 0609354 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (Pennsylvania) | Primary |
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