Main Street Medical Center INC

NPI #1063561041 in Shenandoah, Pennsylvania

Provider Information

NPI Number: 1063561041
Entity Type: Organization
Organization Name: Main Street Medical Center INC
Primary Specialty: Internal Medicine
Enumeration Date: Jan 9, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 24 SOUTH MAIN STREET
City: Shenandoah
State: Pennsylvania
ZIP Code: 17976
Phone: (570) 462-1033

Authorized Official

Name: MR. ADOLPH MICHAEL WYCHULIS, MD
Title: OWNER
Phone: (570) 462-1033

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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