Provider Demographics
NPI:1700916244
Name:M.S.U.R., M.D., ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:M.S.U.R., M.D., ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARSIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-826-6875
Mailing Address - Street 1:166 HANOVER ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-3549
Mailing Address - Country:US
Mailing Address - Phone:570-826-6875
Mailing Address - Fax:570-829-2280
Practice Address - Street 1:166 HANOVER ST
Practice Address - Street 2:SUITE 305
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-3549
Practice Address - Country:US
Practice Address - Phone:570-826-6875
Practice Address - Fax:570-829-2280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011554840006OtherMEDICAID
PA812956OtherFIRST PRIORITY HEALTH
PA1484OtherGEISINGER HEALTH PLAN
PA164990OtherHIGHMARK BLUE SHIELD
PA164990OtherFIRST PRIORITY LIFE INSUR
PA2Y28128OtherHEALTH NET
PA164990OtherFIRST PRIORITY LIFE INSUR
PA2Y28128OtherHEALTH NET