PARTICIPATING PROVIDER AGREEMENT WITH HIGHMARK BLUE SHIELDParticipating Provider Agreement • May 14th, 2003
Contract Type FiledMay 14th, 2003Under the applicable laws of the Commonwealth of Pennsylvania, I am duly authorized to engage in the practice of . In consideration of being registered by Highmark Inc. d/b/a Highmark Blue Shield, an independent licensee of the Blue Cross and Blue Shield Association (hereinafter termed "Blue Shield"), as a participating provider, I do hereby agree as follows: