Organization
HERITAGE VALLEY MEDICAL GROUP, INC
Active
Other names
HVMG Family Practice Associates Moon
Organization subpart
No
Provider details
NPI number
Authorized official
NORMAN F. MITRY (PRESIDENT & CEO)
(724) 773-4776
Entity
Organization
Contact information
Practice address
993 BRODHEAD RD, MOON TOWNSHIP, PA 15108-2331
(412) 264-1918
(412) 264-9114
Mailing address
993 BRODHEAD RD, MOON TOWNSHIP, PA 15108-2331
(412) 264-1918
(412) 264-9114
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014950830029
—
PA
05
—
2297465
—
OH
Enumeration date
10/15/2008
Last updated
06/29/2012
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