Provider Demographics
NPI:1366409872
Name:LABERGE, ANNE-MARIE (MD MSC BCEM)
Entity type:Individual
Prefix:DR
First Name:ANNE-MARIE
Middle Name:
Last Name:LABERGE
Suffix:
Gender:F
Credentials:MD MSC BCEM
Other - Prefix:
Other - First Name:ANNE-MARIE
Other - Middle Name:
Other - Last Name:CLERMONT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 951806
Mailing Address - Street 2:ELLWOOD EMERGENCY PHYSICIANS INC
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-0020
Mailing Address - Country:US
Mailing Address - Phone:800-666-2455
Mailing Address - Fax:610-660-9384
Practice Address - Street 1:724 PERSHING ST
Practice Address - Street 2:ELLWOOD CITY HOSPITAL
Practice Address - City:ELLWOOD CITY
Practice Address - State:PA
Practice Address - Zip Code:16117
Practice Address - Country:US
Practice Address - Phone:724-752-6744
Practice Address - Fax:610-617-6280
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD052139L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA022005Medicare ID - Type Unspecified
G88067Medicare UPIN