Provider Demographics
NPI:1093720732
Name:MCVAY, EDWARD J (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:J
Last Name:MCVAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1910 SASSAFRAS ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-2716
Mailing Address - Country:US
Mailing Address - Phone:814-452-7879
Mailing Address - Fax:814-452-7161
Practice Address - Street 1:1910 SASSAFRAS ST
Practice Address - Street 2:SUITE 200
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-2716
Practice Address - Country:US
Practice Address - Phone:814-452-7879
Practice Address - Fax:814-452-7161
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD-042160-L2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001463464Medicaid
PA000435779OtherBLUE CROSS
PA000435779OtherBLUE CROSS
PA001463464Medicaid