Provider Demographics
NPI:1073563144
Name:POPE, MARY ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:ANNE
Last Name:POPE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 NEW SALEM RD
Mailing Address - Street 2:SUITE 116
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-8936
Mailing Address - Country:US
Mailing Address - Phone:724-437-0729
Mailing Address - Fax:724-437-2761
Practice Address - Street 1:125 CHAFFEE ST
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-4605
Practice Address - Country:US
Practice Address - Phone:724-434-5437
Practice Address - Fax:724-437-2761
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-040126-L2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011061020007Medicaid
510873OtherHIGHMARK
A72369Medicare UPIN
510873OtherHIGHMARK