Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Indiana Regional Medical Center

Organization Internal Medicine Physician · NPI 1104055946

Indiana Regional Medical Center is an Internal Medicine Physician in Blairsville, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2009.

Licensed in
PA
In the registry since
2009
Specialties on file
2

Practice location Partly verified

Some contact details are missing from the federal record.

Indiana At Chestnut Ridge 25 Colony Blvd
Blairsville, PA 15717
Phone: (724) 357-7009
Fax: (724) 357-7414
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 090701 (PA)
Urgent Care Clinic/Center Taxonomy 261QU0200X · Licence 090701 (PA)

Record details

NPI number1104055946
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Ickowski — Chief Financial Officer · (724) 357-7008
NPI enumeratedJuly 14, 2009
Last updated in NPPESJuly 10, 2024
Certification dateJuly 10, 2024
Mailing addressPo Box 788, 835 Hospital Road, Indiana, PA 15701-0788

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