Provider Demographics
NPI:1659380111
Name:SOMERSET CENTRAL MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:SOMERSET CENTRAL MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-443-6588
Mailing Address - Street 1:223 S PLEASANT AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SOMERSET
Mailing Address - State:PA
Mailing Address - Zip Code:15501-2183
Mailing Address - Country:US
Mailing Address - Phone:814-443-6588
Mailing Address - Fax:814-445-9688
Practice Address - Street 1:223 S PLEASANT AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-2183
Practice Address - Country:US
Practice Address - Phone:814-443-6588
Practice Address - Fax:814-445-9688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011030940005Medicaid
PA0000891696OtherHIGHMARK BLUE SHIELD
PA0000891696OtherHIGHMARK BLUE SHIELD