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Organization
TRI-STATE MEDICAL GROUP, INC.
Active
Organization
TRI-STATE MEDICAL GROUP, INC.
Active
Parent organization
TRI-STATE MEDICAL GROUP, INC.
Other names
TSMG Center Medical Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRI-STATE MEDICAL GROUP, INC.
Authorized official
NORMAN MITRY (PRESIDENT & CEO)
(724) 773-4776
Entity
Organization
Contact information
Practice address
99 AUTUMN ST, SUITE 101, ALIQUIPPA, PA 15001-1301
(724) 375-3100
Mailing address
99 AUTUMN ST, SUITE 101, ALIQUIPPA, PA 15001-1301
(724) 375-3100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015654460023
—
PA
05
—
0202677
—
OH
Enumeration date
10/13/2008
Last updated
10/13/2008
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