Organization
FAYETTE OB/GYN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLEY WILSON (BILLER)
(724) 430-6200
Entity
Organization
Contact information
Practice address
404 W MAIN ST, UNIONTOWN, PA 15401-2868
(724) 430-6200
(724) 430-6250
Mailing address
404 W MAIN ST, UNIONTOWN, PA 15401-2868
(724) 430-6200
(724) 430-6250
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
Primary
SP013519
PA
Other
Enumeration date
12/13/2013
Last updated
12/13/2013
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