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Individual

JAY E ENDRES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
12 ELM ST, WARREN, PA 16365
(814) 723-3520
(814) 726-2988
Mailing address
12 ELM ST, WARREN, PA 16365
(814) 723-3520
(814) 726-2988

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD039470L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001022675
PA
01
040600
HIGHMARK
PA
01
422220
HIGHMARK
PA
Enumeration date
03/08/2006
Last updated
02/03/2016
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