Provider Demographics
NPI:1083671846
Name:MAYERNIK, DAVID GREGORY (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:GREGORY
Last Name:MAYERNIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:247 MOREWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-1861
Mailing Address - Country:US
Mailing Address - Phone:412-622-0290
Mailing Address - Fax:412-681-7605
Practice Address - Street 1:2626 HAYMAKER RD FL 2
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3516
Practice Address - Country:US
Practice Address - Phone:412-373-4411
Practice Address - Fax:412-373-4677
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD020910E207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009785120010Medicaid
PAB37074Medicare UPIN
PA118112SDBMedicare PIN