| Tri-state Medical Group, Inc | |
|
1185 Freedom Rd Suite B106 Cranberry Twp PA 16066-4913 | |
| (724) 777-3596 | |
| Not Available |
| Full Name | Tri-state Medical Group, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1185 Freedom Rd, Cranberry Twp, Pennsylvania |
| Authorized Official Name and Position | Norman F Mitry (PRESIDENT & CEO) |
| Authorized Official Contact | 7247734776 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tri-state Medical Group, Inc 1185 Freedom Rd Suite B106 Cranberry Twp PA 16066-4913 Ph: (724) 773-5964 | Tri-state Medical Group, Inc 1185 Freedom Rd Suite B106 Cranberry Twp PA 16066-4913 Ph: (724) 777-3596 |
| NPI Number | 1841429099 |
|---|---|
| Provider Enumeration Date | 07/09/2009 |
| Last Update Date | 07/09/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841429099 | NPI | - | NPPES |
| 0015654460023 | Medicaid | PA | |
| 0202677 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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