Organization
GASTROINTESTINAL CONSULTANTS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD C LEIB JR M.D. (PRESIDENT)
(814) 535-2511
Entity
Organization
Contact information
Practice address
350 SOUTHMONT BLVD, JOHNSTOWN, PA 15905-2818
(814) 535-2511
(814) 535-8473
Mailing address
350 SOUTHMONT BLVD, JOHNSTOWN, PA 15905-2818
(814) 535-2511
(814) 535-8473
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006437800002
—
PA
01
—
091720
BLUE SHIELD
PA
01
—
MEDPLUS
MEDPLUS
PA
Enumeration date
09/29/2006
Last updated
06/11/2008
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