Organization
MON VALE ORTHOPEDIC GROUP, INC.
Active
Other names
The Orthopedic Group, PC
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA FERGUSON (BUSINESS MANAGER)
(724) 379-5802
Entity
Organization
Contact information
Practice address
371 SKYLINE DR, CALIFORNIA, PA 15419-1278
(724) 648-3862
(724) 938-3039
Mailing address
800 PLAZA DRIVE, SUITE 400, BELLE VERNON, PA 15012-4019
(724) 379-5816
(724) 379-5874
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011318300010
—
PA
01
—
150719
HIGHMARK BC BS
—
Enumeration date
07/13/2018
Last updated
05/24/2019
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