Basic Information
| Provider Information | |||||||||
| NPI: | 1164429593 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STURM | ||||||||
| FirstName: | PATRICK | ||||||||
| MiddleName: | WILLIAM | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1201 3RD ST | ||||||||
| Address2: | |||||||||
| City: | BEAVER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150092530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7247742942 | ||||||||
| FaxNumber: | 7247707943 | ||||||||
| Practice Location | |||||||||
| Address1: | 1201 3RD ST | ||||||||
| Address2: | |||||||||
| City: | BEAVER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150092530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7247742942 | ||||||||
| FaxNumber: | 7247707943 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2005 | ||||||||
| LastUpdateDate: | 09/16/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | MD028685E | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | 0009340620005 | 05 | PA | MEDICAID | 0724274 | 05 | OH | MEDICAID | 290009108 | 01 | RR MEDICARE | OTHER |