Individual
BRIAN MUDRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2175 MCCLELLANDTOWN RD, SUITE 201, MASONTOWN, PA 15461-2593
(724) 583-1401
(724) 583-8550
Mailing address
211 EASY ST, SUITE 127, UNIONTOWN, PA 15401-3129
(724) 430-8755
(724) 434-1659
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS010287L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012694790001
—
PA
01
—
1742037
HIGHMARK
PA
Enumeration date
07/28/2005
Last updated
07/02/2012
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