Organization
CENTRE MEDICAL AND SURGICAL ASSOCIATES, P.C.
Active
Other names
Medicine State College
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN J. MCQUEARY (COO/ADMINISTRATIVE DIRECTOR)
(814) 234-4753
Entity
Organization
Contact information
Practice address
1850 E PARK AVE, SUITE 201, STATE COLLEGE, PA 16803-6706
(814) 234-8800
(814) 234-8068
Mailing address
1850 E PARK AVE, SUITE 201, STATE COLLEGE, PA 16803-6706
(814) 234-8800
(814) 234-8068
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD067665L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007679310027
—
PA
Enumeration date
05/01/2006
Last updated
08/22/2020
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