Provider Demographics
NPI:1124025929
Name:DITOPPA, LOUIS A (DO)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:A
Last Name:DITOPPA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1978 LINCOLN WAY
Mailing Address - Street 2:
Mailing Address - City:WHITE OAK
Mailing Address - State:PA
Mailing Address - Zip Code:15131-2416
Mailing Address - Country:US
Mailing Address - Phone:412-664-0720
Mailing Address - Fax:412-664-7134
Practice Address - Street 1:1978 LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:WHITE OAK
Practice Address - State:PA
Practice Address - Zip Code:15131-2416
Practice Address - Country:US
Practice Address - Phone:412-664-0720
Practice Address - Fax:412-664-7134
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2007-11-02
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
PAOS0005455L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB41966Medicare UPIN
015822Medicare PIN