1871787952 NPI number — G. ALAN YEASTED, MD

Table of content: (NPI 1871787952)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871787952 NPI number — G. ALAN YEASTED, MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
G. ALAN YEASTED, MD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1871787952
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/31/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3515 WASHINGTON RD
Provider Second Line Business Mailing Address:
SUITE 570
Provider Business Mailing Address City Name:
MC MURRAY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15317-3063
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-572-6066
Provider Business Mailing Address Fax Number:
412-561-0785

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3515 WASHINGTON RD
Provider Second Line Business Practice Location Address:
SUITE 570
Provider Business Practice Location Address City Name:
MC MURRAY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15317-3063
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-572-6066
Provider Business Practice Location Address Fax Number:
412-561-0785
Provider Enumeration Date:
08/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
YEASTED
Authorized Official First Name:
G. ALAN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
412-572-6066

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , 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: 1544856 . This is a "GATEWAY MEDICARE ASSURED" identifier . This identifiers is of the category "OTHER".
  • Identifier: 102028 . This is a "UPMC HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 148680 . This is a "HEALTH AMERICA" identifier . This identifiers is of the category "OTHER".




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