Basic Information
| Provider Information | |||||||||
| NPI: | 1508894668 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TCHIRKOW | ||||||||
| FirstName: | GEORGE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1050 BOWER HILL ROAD | ||||||||
| Address2: | SUITE 208 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15243 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4125726192 | ||||||||
| FaxNumber: | 4125726193 | ||||||||
| Practice Location | |||||||||
| Address1: | 1050 BOWER HILL RD | ||||||||
| Address2: | SUITE 208 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15243 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4125726192 | ||||||||
| FaxNumber: | 4125726193 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208C00000X | MD028227E | PA | Y | Allopathic & Osteopathic Physicians | Colon & Rectal Surgery |
ID Information
| ID | Type | State | Issuer | Description | 0939926 | 05 | PA | MEDICAID |