Organization
FIFTH AVENUE MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE MOATS (CENTER DIRECTOR)
(717) 217-4312
Entity
Organization
Contact information
Practice address
835 5TH AVE, CHAMBERSBURG, PA 17201-4224
(717) 217-4312
(717) 217-4314
Mailing address
835 5TH AVE, CHAMBERSBURG, PA 17201-4224
(717) 217-4312
(717) 217-4314
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
06/21/2006
Last updated
11/08/2019
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