Provider Demographics
NPI:1003835737
Name:PATRICK, GREGORY B (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:B
Last Name:PATRICK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:701 BROAD STREET
Mailing Address - Street 2:SUITE 411
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143
Mailing Address - Country:US
Mailing Address - Phone:412-749-7160
Mailing Address - Fax:412-749-7388
Practice Address - Street 1:701 BROAD STREET
Practice Address - Street 2:SUITE 411
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143
Practice Address - Country:US
Practice Address - Phone:412-749-7160
Practice Address - Fax:412-749-7388
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2015-09-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD019549E207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007977310011Medicaid
B36522Medicare UPIN
PA103644LCKMedicare PIN