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Individual

JOHN M TREVEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
575 N RIVER ST, WILKES BARRE, PA 18764-0999
(570) 829-8111
Mailing address
PO BOX 1676, KINGSTON, PA 18704-0676
(570) 714-5525
(570) 714-5548

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
OS006927L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0014411710007
PA
Enumeration date
05/12/2006
Last updated
10/18/2011
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