Provider Demographics
NPI:1588960934
Name:METABOLIC DISEASE ASSOCIATES
Entity type:Organization
Organization Name:METABOLIC DISEASE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:ESTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-452-2218
Mailing Address - Street 1:240 W 11TH ST
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16501-1758
Mailing Address - Country:US
Mailing Address - Phone:814-452-2218
Mailing Address - Fax:814-452-4639
Practice Address - Street 1:240 W 11TH ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16501-1758
Practice Address - Country:US
Practice Address - Phone:814-452-2218
Practice Address - Fax:814-452-4639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-02
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty