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Organization
SEWICKLEY VALLEY MEDICAL GROUP INC
Active
Organization
SEWICKLEY VALLEY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NORMAN F MITRY (PRESIDENT AND CEO)
(724) 773-4779
Entity
Organization
Contact information
Practice address
701 BROAD ST, STE B FLR 4, SEWICKLEY, PA 15143-1652
(412) 741-0985
(412) 741-7539
Mailing address
2 PEARTREE WAY, BEAVER, PA 15009-1954
(724) 728-4171
(724) 728-2019
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
208D00000X
General Practice Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014950830029
—
PA
Enumeration date
05/27/2006
Last updated
10/30/2007
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