Provider Demographics
NPI:1083705883
Name:YEASTED, GEORGE ALAN (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:ALAN
Last Name:YEASTED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1369 WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15228
Mailing Address - Country:US
Mailing Address - Phone:412-561-0820
Mailing Address - Fax:412-561-0785
Practice Address - Street 1:1000 BOWER HILL RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243
Practice Address - Country:US
Practice Address - Phone:412-344-6600
Practice Address - Fax:412-572-6933
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD016944E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B34845Medicare UPIN
PAYE69068Medicare ID - Type Unspecified