Provider Demographics
NPI:1568171874
Name:SALAH MOHAMMED MUSTAFA ALDERGASH MD
Entity Type:Organization
Organization Name:SALAH MOHAMMED MUSTAFA ALDERGASH MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SALAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ALDERGASH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-788-4995
Mailing Address - Street 1:100 HEINZ CT
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-1764
Mailing Address - Country:US
Mailing Address - Phone:412-788-4995
Mailing Address - Fax:412-788-0250
Practice Address - Street 1:100 HEINZ CT
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-1764
Practice Address - Country:US
Practice Address - Phone:412-788-4995
Practice Address - Fax:412-788-0250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty