Organization
FAYETTE MEDICAL ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLENE PULICE (MEDICAL BILLER)
(724) 425-8317
Entity
Organization
Contact information
Practice address
112 YOUNGSTOWN RD, SUITE 101, LEMONT FURNACE, PA 15456-1344
(724) 432-5831
(724) 425-8326
Mailing address
112 YOUNGSTOWN RD, SUITE 101, LEMONT FURNACE, PA 15456-1344
(724) 432-5831
(724) 425-8326
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015441410020
—
PA
01
—
4441
UPMC
PA
01
—
782000
HIGHMARK
PA
01
—
CC8758
RAILROAD MEDICARE
PA
Enumeration date
07/28/2005
Last updated
07/21/2022
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