1467451260 NPI number — DR. CAREY LEE MCMONAGLE M.D.

Table of content: GREGORY BROWN (NPI 1457805335)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467451260 NPI number — DR. CAREY LEE MCMONAGLE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCMONAGLE
Provider First Name:
CAREY
Provider Middle Name:
LEE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467451260
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/04/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1910 COCHRAN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15220-1203
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-531-2902
Provider Business Mailing Address Fax Number:
412-531-2948

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
202 JACOB MURPHY LN
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
UNIONTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15401-2686
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-912-0035
Provider Business Practice Location Address Fax Number:
724-912-0036
Provider Enumeration Date:
07/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  MD016826-E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 214422 . This is a "UPMC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 4304177 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 155000 . This is a "BLUE SHIELD/KEYSTONE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2926 . This is a "MT. STATE BLUE SHIELD" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 1027817 . This is a "GATEWAY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 732942 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: B40110 . This is a "HEALTH AMERICA/ASSUSRANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: B40110 . This is a "ADVANTRA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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