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Individual

DR. JEREMY JAMES MASHBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
348 MAIN ST, GREENVILLE, PA 16125-2608
(724) 588-5250
(724) 588-5253
Mailing address
100 SHENANGO AVE, SHARON, PA 16146-1503
(724) 588-5250
(724) 588-5253

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
34.011238
OH
207Q00000X
Family Medicine Physician
Primary
OS022110
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
34.011238
OHIO MEDICAL LICENSE
OH
05
PENDING
OH
Enumeration date
06/23/2010
Last updated
05/18/2023
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