Organization
FAIRWAY PRIMARY CARE, LLC
Active
Organization
FAIRWAY PRIMARY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MELISSA ANN KIFER (OFFICE COORDINATOR)
(814) 942-9494
Entity
Organization
Contact information
Practice address
2950 FAIRWAY DR, SUITE 2, ALTOONA, PA 16602-4457
(814) 942-9494
(814) 942-4399
Mailing address
2950 FAIRWAY DR, SUITE 2, ALTOONA, PA 16602-4457
(814) 942-9494
(814) 942-4399
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS010770L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DB9443
RAILROAD MEDICARE
PA
Enumeration date
03/08/2007
Last updated
11/14/2007
Update your record
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