| Integrated Medical Group | |
|
48 Tunnel Rd Suite 203 Pottsville PA 17901-3875 | |
| (570) 622-5455 | |
| (570) 622-5493 |
| Full Name | Integrated Medical Group |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 48 Tunnel Rd, Pottsville, Pennsylvania |
| Authorized Official Name and Position | David Gonzalez (CREDENTIALING CONTACT) |
| Authorized Official Contact | 5706225455 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Medical Group 48 Tunnel Rd Suite 203 Pottsville PA 17901-3875 Ph: (570) 622-5455 | Integrated Medical Group 48 Tunnel Rd Suite 203 Pottsville PA 17901-3875 Ph: (570) 622-5455 |
| NPI Number | 1073577482 |
|---|---|
| Provider Enumeration Date | 04/13/2006 |
| Last Update Date | 04/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073577482 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
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