Provider Demographics
NPI:1164554440
Name:EDWARD M. AUSTIN MD PC
Entity Type:Organization
Organization Name:EDWARD M. AUSTIN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-854-4870
Mailing Address - Street 1:110 FORT COUCH RD
Mailing Address - Street 2:2D FLOOR
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-1030
Mailing Address - Country:US
Mailing Address - Phone:412-854-4870
Mailing Address - Fax:412-854-5034
Practice Address - Street 1:110 FORT COUCH RD
Practice Address - Street 2:2D FLOOR
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-1030
Practice Address - Country:US
Practice Address - Phone:412-854-4870
Practice Address - Fax:412-854-5034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD012846E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008880590002Medicaid
PA59971Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
PA0008880590002Medicaid