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Organization
MEDICAL ASSOCIATES OF ERIE
Active
Organization
MEDICAL ASSOCIATES OF ERIE
Active
Other names
Shoreline Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN NEJMAN (CREDENTIALING SPECIALIST)
(814) 868-2507
Entity
Organization
Contact information
Practice address
2820 W 12TH ST, ERIE, PA 16505-4204
(814) 833-8800
(814) 833-2079
Mailing address
1 LECOM PL, ERIE, PA 16505-2571
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
—
101066458
—
PA
Enumeration date
10/25/2021
Last updated
10/25/2021
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