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Organization
HERITAGE VALLEY MEDICAL GROUP, INC.
Active
Organization
HERITAGE VALLEY MEDICAL GROUP, INC.
Active
Parent organization
HERITAGE VALLEYMEDICAL GROUP, INC.
Other names
HVMG Foot and Ankle
Organization subpart
Yes
Provider details
NPI number
Legal business name
HERITAGE VALLEYMEDICAL GROUP, INC.
Authorized official
BRYAN J RANDALL (VICE PRESIDENT & CFO)
(412) 749-7027
Entity
Organization
Contact information
Practice address
79 WAGNER ROAD, SUITE 103, MONACA, PA 15061-2338
(878) 439-3598
(878) 439-3599
Mailing address
1000 DUTCH RIDGE RD, BEAVER, PA 15009-9727
(724) 773-4776
(724) 773-4726
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00156544
—
PA
Enumeration date
06/10/2019
Last updated
06/10/2019
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