# TRI-STATE MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Heritage Valley Endocrinology Beaver
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730496019
- **Authorized official:** NORMAN F. MITRY (PRESIDENT & CEO)
- **Authorized official phone:** (724) 773-4776

## Contact information

- **Practice address:** 1 PEARTREE WAY, BEAVER, PA 15009-1954
- **Practice address phone:** (724) 773-4776
- **Mailing address:** 1 PEARTREE WAY, BEAVER, PA 15009-1954
- **Mailing address phone:** (724) 773-4776

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/08/2010
- **Last updated:** 09/08/2010