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Organization
HERITAGE VALLEY MEDICAL GROUP, INC
Active
Organization
HERITAGE VALLEY MEDICAL GROUP, INC
Active
Other names
HVMG Family Practice Associates Moon
Organization subpart
No
Provider details
NPI number
Authorized official
NORMAN F. MITRY (PRESIDENT & CEO)
(724) 773-4776
Entity
Organization
Contact information
Practice address
993 BRODHEAD RD, MOON TOWNSHIP, PA 15108-2331
(412) 264-1918
(412) 264-9114
Mailing address
993 BRODHEAD RD, MOON TOWNSHIP, PA 15108-2331
(412) 264-1918
(412) 264-9114
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014950830029
—
PA
05
—
2297465
—
OH
Enumeration date
10/15/2008
Last updated
06/29/2012
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