Provider Demographics
NPI:1881864452
Name:MARK P. SERALY, MD, PC
Entity type:Organization
Organization Name:MARK P. SERALY, MD, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:SERALY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-969-2500
Mailing Address - Street 1:222 E MCMURRAY RD
Mailing Address - Street 2:
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-2948
Mailing Address - Country:US
Mailing Address - Phone:724-969-2500
Mailing Address - Fax:724-969-2510
Practice Address - Street 1:222 E MCMURRAY RD
Practice Address - Street 2:
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-2948
Practice Address - Country:US
Practice Address - Phone:724-969-2500
Practice Address - Fax:724-969-2510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-10
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF75792Medicare UPIN