Basic Information
| Provider Information | |||||||||
| NPI: | 1861804726 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TRANOVICH | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | JONATHAN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 WHEELING AVE | ||||||||
| Address2: | |||||||||
| City: | GLEN DALE | ||||||||
| State: | WV | ||||||||
| PostalCode: | 260381660 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3048453211 | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 MEDICAL BLVD | ||||||||
| Address2: | |||||||||
| City: | CANONSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 153179762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7247456100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2014 | ||||||||
| LastUpdateDate: | 09/28/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 3202 | WV | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 208D00000X | 3202 | WV | N | Allopathic & Osteopathic Physicians | General Practice | 207P00000X | OS019678 | PA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.