| Organization Name: | DUBOIS REGIONAL MEDICAL GROUP, PC |
| NPI Number: | 1093956617 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN S SUTIKA (AUTHORIZED OFFICIAL & SECRETARY) |
| Mailing Address: | 100 Hospital Ave Du Bois |
| State: | PA US |
| Postal Code: | 158011440 |
| Phone Number: | 8143712200 |
| Fax Number: | 8143754232 |
| NPI Enumeration Date: | 03/11/2009 |
| NPI Last Update Date: | 03/07/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2086S0122X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Surgery |
| Taxonomy Specialization: | Plastic and Reconstructive Surgery |
| Taxonomy Definition: | A surgeon who specializes in plastic and reconstructive surgery. |