Basic Information
Provider Information
NPI: 1164539920
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CELKO
FirstName: DAVID
MiddleName: ALBERT
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 455 VALLEYBROOK RD
Address2: SUITE 300
City: MC MURRAY
State: PA
PostalCode: 153173367
CountryCode: US
TelephoneNumber: 7249415588
FaxNumber: 7249411458
Practice Location
Address1: 455 VALLEYBROOK RD
Address2: SUITE 300
City: MC MURRAY
State: PA
PostalCode: 153173367
CountryCode: US
TelephoneNumber: 7249415588
FaxNumber: 7249411458
Other Information
ProviderEnumerationDate: 08/25/2006
LastUpdateDate: 11/11/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/11/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001XMD-018247EPAY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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