Basic Information
| Provider Information | |||||||||
| NPI: | 1639328461 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SEVILLA | ||||||||
| FirstName: | WEDNESDAY MARIE | ||||||||
| MiddleName: | ABAYA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4401 PENN AVE | ||||||||
| Address2: | 6TH FLOOR FACULTY PAVILION | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152241334 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126925180 | ||||||||
| FaxNumber: | 4126927355 | ||||||||
| Practice Location | |||||||||
| Address1: | 4401 PENN AVE | ||||||||
| Address2: | 6TH FLOOR FACULTY PAVILION | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152241334 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126925180 | ||||||||
| FaxNumber: | 4126927355 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2008 | ||||||||
| LastUpdateDate: | 01/30/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 49387 | TN | N | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 2080P0206X | MD458481 | PA | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Gastroenterology |
No ID Information.