Organization
COMMONWEALTH DERMATOLOGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW SHANE PETRIE M.D. (PRESIDENT)
(336) 403-5331
Entity
Organization
Contact information
Practice address
3055 WASHINGTON RD, SUITE 203, MC MURRAY, PA 15317-3279
(724) 260-5424
(724) 260-5425
Mailing address
3055 WASHINGTON RD, SUITE 203, MC MURRAY, PA 15317-3279
(724) 260-5424
(724) 260-5425
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD438908
PA
207ND0101X
MOHS-Micrographic Surgery Physician
MD438908
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103091870-0001
—
PA
Enumeration date
04/04/2016
Last updated
06/06/2016
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