Individual
CAN BAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
132 ABIGAIL LN, PORT MATILDA, PA 16870-7153
(814) 272-5011
(814) 272-6531
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(814) 272-5011
(814) 272-6531
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD489094
PA
Other
Enumeration date
10/30/2023
Last updated
07/16/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us