| Dubois Regional Medical Group, Pc | |
|
145 Hospital Ave Ste 104 Du Bois PA 15801-1463 | |
| (814) 375-8055 | |
| (814) 375-8056 |
| Full Name | Dubois Regional Medical Group, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 145 Hospital Ave Ste 104, Du Bois, Pennsylvania |
| Authorized Official Name and Position | John S Sutika (AUTHORIZED OFFICIAL & SECRETARY) |
| Authorized Official Contact | 8143753385 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dubois Regional Medical Group, Pc 100 Hospital Ave Du Bois PA 15801-1440 Ph: (814) 375-4200 | Dubois Regional Medical Group, Pc 145 Hospital Ave Ste 104 Du Bois PA 15801-1463 Ph: (814) 375-8055 |
| NPI Number | 1093956617 |
|---|---|
| Provider Enumeration Date | 03/11/2009 |
| Last Update Date | 10/14/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093956617 | NPI | - | NPPES |
| 063246 | Other | PA | PTAN |
| 100751931 | Medicaid | PA |
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