Gavin, George M

Gavin, George M is an individual health care provider with primary practice located at 555 Route 217 Suite 1, Latrobe PA 15650-3428. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gavin, George M can be contacted via phone (724) 694-2723.

Contact Information

Primary practice address
555 Route 217 Suite 1 Latrobe PA 15650-3428
Fax: (724) 694-8830
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD024099E Pennsylvania

Profile Details

NPI number 1659359545
LBN Legal business name Gavin, George M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 3rd, 2006
Last updated Nov 13th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659359545 NPPES
Pennsylvania MEDICAID 0008660980004

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