Main Street Medical Center Inc in Shenandoah - Internal Medicine
Main Street Medical Center Inc - NPI 1063561041
Main Street Medical Center Inc is a Internal Medicine in Shenandoah, Pennsylvania. Main Street Medical Center Inc practices all healthcare services and medical treatments related to Internal Medicine. The NPI Number for Main Street Medical Center Inc is 1063561041. The last update date is 2020-08-22.
Main Street Medical Center Inc's current location address is 24 South Main Street, Shenandoah, Pennsylvania. You can contact this provider via phone number 5704621033 and fax number 5704621171. The mailing address for Main Street Medical Center Inc is 24 South Main Street, Shenandoah, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Main Street Medical Center Inc |
|---|---|
| Address | 24 South Main Street, Shenandoah, Pennsylvania |
| Phone Number | 5704621033 |
| Fax Number | 5704621171 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Wychulis Michael Adolph |
| Credentials | MD |
| Telephone Number | 5704621033 |
NPI Number Detail
| NPI Number | 1063561041 |
|---|---|
| Provider Enumeration Date | 2007-01-09 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 24 South Main Street |
|---|---|
| City | Shenandoah |
| State | Pennsylvania (PA) |
| Post Code | 17976 |
| Phone Number | 5704621033 |
| Fax Number | 5704621171 |
Provider's Primary Taxonomy Detail
| Speciality | Internal Medicine |
|---|---|
| Taxonomy | 207R00000X |
| Licence No | MD418365 |
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Definition: A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and di |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 19487500001 | PA | -- |
Post Comment/ Review Below
What is the Main Street Medical Center Inc's 1063561041?
The Main Street Medical Center Inc's NPI (National Provider Identifier) Number is 1063561041. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Where is the Main Street Medical Center Inc located?
The Main Street Medical Center Inc is located at 24 South Main Street, Shenandoah, PA 17976.
Could you please provide the complete physical location address of Main Street Medical Center Inc?
The Main Street Medical Center Inc is physically situated at 24 South Main Street, in the city of Shenandoah, state of PA, with the postal code 17976.
What is the Main Street Medical Center Inc's specialty and taxonomy code?
The Main Street Medical Center Inc's specialty is Internal Medicine, and the corresponding taxonomy code is 207R00000X.
When was the Main Street Medical Center Inc's 1063561041 issued?
The Main Street Medical Center Inc's 1063561041 was issued on 2007-01-09.