Provider Demographics
NPI:1588677900
Name:WESTMORELAND GASTROENTEROLOGY INC.
Entity Type:Organization
Organization Name:WESTMORELAND GASTROENTEROLOGY INC.
Other - Org Name:WESTMORELAND GASTROENTEROLOGY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:DEJESUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-836-5500
Mailing Address - Street 1:545 RUGH ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5636
Mailing Address - Country:US
Mailing Address - Phone:724-836-5500
Mailing Address - Fax:724-836-8471
Practice Address - Street 1:545 RUGH ST
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-5636
Practice Address - Country:US
Practice Address - Phone:724-836-5500
Practice Address - Fax:724-836-8471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1785866OtherHIGHMARK
PA1016190110001Medicaid
PA1785866OtherHIGHMARK