Organization
PORT ALLEGANY AREA FAMILY PRACTICE PC
Active
Other names
UPPER ALLEGHENY MEDICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MARK H SHELLEY M.D. (PRESIDENT)
(814) 642-9531
Entity
Organization
Contact information
Practice address
1 WILLOW ST, PORT ALLEGANY, PA 16743-1332
(814) 642-9531
(814) 642-2020
Mailing address
1 WILLOW ST, PORT ALLEGANY, PA 16743-1332
(814) 642-9531
(814) 642-2020
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD029656E
PA
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363AM0700X
Medical Physician Assistant
MA053689
PA
363LF0000X
Family Nurse Practitioner
SP008214
PA
363LF0000X
Family Nurse Practitioner
SP009929
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014032880001
—
PA
01
—
861827
HIGHMARK BLUE SHIELD
PA
01
—
CF9006
RAILROAD MEDICARE
—
Enumeration date
04/27/2006
Last updated
06/22/2022
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