Basic Information
| Provider Information | |||||||||
| NPI: | 1386737245 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ANTHONY J PINEVICH, MD, PC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | ADVANCE CONSULTANTS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 680 ANDERSEN DR | ||||||||
| Address2: | FOSTER PLAZA 10 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152202759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4129378887 | ||||||||
| FaxNumber: | 4129379221 | ||||||||
| Practice Location | |||||||||
| Address1: | 1400 LOCUST ST | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152195114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4122327330 | ||||||||
| FaxNumber: | 4129379221 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2006 | ||||||||
| LastUpdateDate: | 07/28/2010 | ||||||||
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| AuthorizedOfficialLastName: | PINEVICH | ||||||||
| AuthorizedOfficialFirstName: | ANTHONY | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 4122327330 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | MD037574E | PA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
ID Information
| ID | Type | State | Issuer | Description | DF6941 | 01 | PA | RR MEDICARE | OTHER | 1017493010001 | 05 | PA | MEDICAID | 1904606 | 01 | PA | HIGHMARK BCBS | OTHER |