Kanouse Medical Group PC

NPI #1790859783 in Berwick, Pennsylvania

Provider Information

NPI Number: 1790859783
Entity Type: Organization
Organization Name: Kanouse Medical Group PC
Primary Specialty: Internal Medicine
Enumeration Date: Nov 20, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 695 E 16TH ST
Address 2: SUITE D
City: Berwick
State: Pennsylvania
ZIP Code: 18603-2320
Phone: (570) 752-5500

Authorized Official

Name: DR. GARY DOUGLAS KANOUSE, MD
Title: PHYSICIAN
Phone: (570) 752-5500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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