| NPI | 1154363893 |
|---|---|
| Former Legal Business Name | OUTHWEST GASTROENTEROLOGY ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | RICHARD J PANICCO President 724-941-3020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2020-06-22 |