Organization
INTERNAL MEDICINE OF BERWICK PC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAVEL PRIBULA M.D. (OWNER)
(570) 752-5056
Entity
Organization
Contact information
Practice address
751 E 16TH ST, SUITE300, BERWICK, PA 18603-2321
(570) 752-5056
Mailing address
751 E 16TH ST, SUITE300, BERWICK, PA 18603-2321
(570) 752-5056
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD067594L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0075190570002
—
PA
01
—
010093500
BLACK LUNG
PA
01
—
02305400
CAPITAL BLUE CROSS
PA
01
—
1348169
HIGHMARK BLUE SHIELD
PA
01
—
1533376
GATEWAY
PA
01
—
221084
FIRST PRIORITY HEALTH
PA
Enumeration date
06/11/2006
Last updated
08/12/2013
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