Provider Demographics
NPI:1205912623
Name:JOSEPH H NOUR MD PC
Entity type:Organization
Organization Name:JOSEPH H NOUR MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:H
Authorized Official - Last Name:NOUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-431-0609
Mailing Address - Street 1:171 OMNI ST
Mailing Address - Street 2:
Mailing Address - City:FOMBELL
Mailing Address - State:PA
Mailing Address - Zip Code:16123-2109
Mailing Address - Country:US
Mailing Address - Phone:724-431-0609
Mailing Address - Fax:724-431-0611
Practice Address - Street 1:1677 ROUTE 65
Practice Address - Street 2:
Practice Address - City:ELLWOOD CITY
Practice Address - State:PA
Practice Address - Zip Code:16117-5217
Practice Address - Country:US
Practice Address - Phone:724-431-0609
Practice Address - Fax:724-431-0611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD051358L207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101490446001Medicaid
PA098044Medicare ID - Type UnspecifiedGROUP ID