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Organization
MEDICAL ASSOCIATES OF ERIE
Active
Organization
MEDICAL ASSOCIATES OF ERIE
Active
Other names
West Lake Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS M STYN (PRESIDENT/CEO)
(814) 868-2504
Entity
Organization
Contact information
Practice address
3435 W LAKE RD, ERIE, PA 16505-3661
(814) 835-6633
(814) 835-6637
Mailing address
1 LECOM PL, ERIE, PA 16505-2571
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101066458
—
PA
Enumeration date
04/14/2011
Last updated
04/14/2011
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