Stone Ridge Medical Group Sc
NPI #1306097894 in East Moline, Illinois
Provider Information
- NPI Number
- 1306097894
- Entity Type
- Organization
- Organization Name
- Stone Ridge Medical Group Sc
- Primary Specialty
- Family Medicine
- Enumeration Date
- Oct 2, 2008
- Last Updated
- Oct 2, 2008
Practice Location
- Address
- 306 46TH AVE
- City
- East Moline
- State
- Illinois
- ZIP Code
- 61244-4281
- Phone
- (309) 796-2329
Authorized Official
- Name
- JAMES PETRE, MD
- Title
- PRESIDENT
- Phone
- (309) 796-2329
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
| Physician Assistant - Medical — Medical |
| Nurse Practitioner |
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