Provider Demographics
NPI:1053445650
Name:BRANCH, ROBERT A (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:BRANCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:100 TECHNOLOGY DR
Mailing Address - Street 2:SUITE 450
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-3138
Mailing Address - Country:US
Mailing Address - Phone:412-383-7824
Mailing Address - Fax:412-648-1880
Practice Address - Street 1:200 LOTHROP ST
Practice Address - Street 2:MONTEFIORE 6 NE
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2536
Practice Address - Country:US
Practice Address - Phone:412-648-6530
Practice Address - Fax:412-802-8668
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD043670L208U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208U00000XAllopathic & Osteopathic PhysiciansClinical Pharmacology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01259317Medicaid
PAB03243Medicare UPIN
PA688231Medicare ID - Type Unspecified