Provider Demographics
NPI:1124040449
Name:YOUNG, ADRIENNE MICHELE (MD)
Entity Type:Individual
Prefix:DR
First Name:ADRIENNE
Middle Name:MICHELE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:27 HECKEL RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:MC KEES ROCKS
Mailing Address - State:PA
Mailing Address - Zip Code:15136-1616
Mailing Address - Country:US
Mailing Address - Phone:412-771-0555
Mailing Address - Fax:412-771-0455
Practice Address - Street 1:27 HECKEL RD
Practice Address - Street 2:SUITE 205
Practice Address - City:MC KEES ROCKS
Practice Address - State:PA
Practice Address - Zip Code:15136-1616
Practice Address - Country:US
Practice Address - Phone:412-771-0555
Practice Address - Fax:412-771-0455
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD042043E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011421720012Medicaid
PA0011421720012Medicaid
PA0011421720010Medicare ID - Type Unspecified
F05983Medicare UPIN
PA533800Medicare ID - Type Unspecified