Integrated Medical Group | |
48 Tunnel Rd Suite 203 Pottsville PA 17901-3875 | |
(570) 622-5455 | |
(570) 622-5493 |
Full Name | Integrated Medical Group |
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Speciality | Internal Medicine |
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 |
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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 | 1366406761 |
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Provider Enumeration Date | 04/13/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366406761 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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Integrated Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 48 Tunnel Rd, Suite 203, Pottsville, PA 17901 Phone: 570-622-5455 Fax: 570-622-5493 |