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Individual

JOHN A CONSALVO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1400 MAIN ST, PECKVILLE, PA 18452-2009
(570) 489-7546
Mailing address
2000 GREEN RD, SUITE 300, ANN ARBOR, MI 48105-1598
(734) 995-3764

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD025156E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0009688010014
PA
01
0041657000
INDEPENDENCE BC
PA
01
414646
HIGHMARK BS
PA
Enumeration date
05/13/2006
Last updated
01/27/2011
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