Provider Demographics
NPI:1306453865
Name:MON-VALE SPECIALTY PRACTICES, INC
Entity type:Organization
Organization Name:MON-VALE SPECIALTY PRACTICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER RELATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-379-4011
Mailing Address - Street 1:1163 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:MONONGAHELA
Mailing Address - State:PA
Mailing Address - Zip Code:15063-1013
Mailing Address - Country:US
Mailing Address - Phone:724-258-1895
Mailing Address - Fax:877-325-1933
Practice Address - Street 1:1163 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:MONONGAHELA
Practice Address - State:PA
Practice Address - Zip Code:15063-1013
Practice Address - Country:US
Practice Address - Phone:724-258-1895
Practice Address - Fax:877-325-1933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty