Organization
INTERNAL MEDICINE OF BERWICK PC INC
Active
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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