INTEGRATED MEDICAL GROUP NPI 1073577482

NPI Information

  • NPI: 1073577482
  • Provider Name: INTEGRATED MEDICAL GROUP
  • Classification: Internal Medicine - 207RG0100X
  • Specialization: Gastroenterology
  • Entity Type: Organization
  • Address: 48 TUNNEL RD
    SUITE 203
    POTTSVILLE, PA
    ZIP 17901
  • Phone: (570) 622-5455

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NPI Details

INTEGRATED MEDICAL GROUP is a gastroenterology internal medicine in Pottsville, PA. The provider is an internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. INTEGRATED MEDICAL GROUP NPI is 1073577482. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

48 TUNNEL RD
SUITE 203
POTTSVILLE, PA
ZIP 17901-875
Phone: (570) 622-5455
Fax: (570) 622-5493

The provider's authorized official is David Gonzalez .
The authorized official title is Credentialing Contact and has the following contact phone number (570) 622-5455.

The enumeration date for this NPI number is 4/13/2006 and was last updated on 4/11/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse PractitionerNo
2207RG0100XInternal MedicineGastroenterologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1001068MEDICARE PINPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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