Provider Demographics
NPI:1235103896
Name:KANDIL, HOSSAM M (MD)
Entity Type:Individual
Prefix:DR
First Name:HOSSAM
Middle Name:M
Last Name:KANDIL
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 1:1307 FEDERAL ST
Mailing Address - Street 2:STE B100
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4769
Mailing Address - Country:US
Mailing Address - Phone:412-359-8900
Mailing Address - Fax:412-359-8977
Practice Address - Street 1:1307 FEDERAL ST
Practice Address - Street 2:STE B100
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4769
Practice Address - Country:US
Practice Address - Phone:412-359-8900
Practice Address - Fax:412-359-8977
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD068316L207RG0100X, 207RG0100X
NC2010-01728207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001794930Medicaid
11345503OtherCAQH
PA001794930Medicaid
NCP00963708OtherRAILROAD MEDICARE
PAH12761Medicare UPIN
NC5917188Medicaid