# HERITAGE VALLEY MEDICAL GROUP, INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** HVMG Family Practice Associates Moon
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124270707
- **Authorized official:** NORMAN F. MITRY (PRESIDENT & CEO)
- **Authorized official phone:** (724) 773-4776

## Contact information

- **Practice address:** 993 BRODHEAD RD, MOON TOWNSHIP, PA 15108-2331
- **Practice address phone:** (412) 264-1918
- **Practice address fax:** (412) 264-9114
- **Mailing address:** 993 BRODHEAD RD, MOON TOWNSHIP, PA 15108-2331
- **Mailing address phone:** (412) 264-1918
- **Mailing address fax:** (412) 264-9114

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/15/2008
- **Last updated:** 06/29/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0014950830029 | — | PA |
| 05 | — | 2297465 | — | OH |