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443 Frye Farm Road Suite 200 Greensburg PA 15601 | |
| (724) 532-2801 | |
| (724) 532-2757 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 443 Frye Farm Road, Greensburg, Pennsylvania |
| Authorized Official Name and Position | William J Provance (SR. PARTNER) |
| Authorized Official Contact | 7245322801 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
443 Frye Farm Road Suite 200 Greensburg PA 15601 Ph: (724) 532-2801 | 443 Frye Farm Road Suite 200 Greensburg PA 15601 Ph: (724) 532-2801 |
| NPI Number | 1851463822 |
|---|---|
| Provider Enumeration Date | 11/15/2006 |
| Last Update Date | 05/20/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851463822 | NPI | - | NPPES |
| 0015669440003 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (Pennsylvania) | Primary |
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