Provider Demographics
NPI:1164482485
Name:REILLY, PATRICK G (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:G
Last Name:REILLY
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 1:1000 BOWER HILL ROAD
Mailing Address - Street 2:ATTN ST CLAIR HOSPITAL - AFFILIATE BILLING - PAMALYN
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1873
Mailing Address - Country:US
Mailing Address - Phone:412-942-2548
Mailing Address - Fax:
Practice Address - Street 1:1050 BOWER HILL RD STE 306
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1870
Practice Address - Country:US
Practice Address - Phone:412-942-5620
Practice Address - Fax:412-942-5639
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042769L174400000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA56-2589074OtherHEALTH AMERICA
PA644756OtherHIGHMARK
PA205808OtherUPMC
PA56-2589074OtherINTERGROUP
PA0012853350005Medicaid
PA0012853350001Medicaid
PA56-2589074OtherUNITED HEALTHCARE
PA1049230OtherCIGNA
PA56-2589074OtherINTERGROUP
PA0012853350005Medicaid