Organization
CENTERVILLE CLINICS - CARMICHAEL X-RAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATTY MARTOS (DIRECTOR FINANCE AND PERSONNEL)
(724) 632-6801
Entity
Organization
Contact information
Practice address
601 W GEORGE ST, CARMICHAELS, PA 15320-1325
(724) 966-5081
Mailing address
1070 OLD NATIONAL PIKE, FREDERICKTOWN, PA 15333-2114
(724) 632-6801
(724) 632-6312
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
380527
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0089
BLUE CROSS OF WESTERN PA.
PA
Enumeration date
04/29/2008
Last updated
04/29/2008
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