Organization
MEADVILLE DIAGNOSTIC MEDICAL IMAGING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERIC T MCDERMOTT MD (MD)
(814) 333-5140
Entity
Organization
Contact information
Practice address
751 LIBERTY STREET, MEADVILLE, PA 16335
(814) 333-5140
(814) 333-5197
Mailing address
7 ACEE DRIVE, NATRONA HEIGHTS, PA 15065
(800) 223-5544
(724) 294-3206
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017610360007
—
PA
Enumeration date
06/07/2006
Last updated
08/22/2020
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