Provider Demographics
NPI:1255306338
Name:POLLOCK, BURTON H (MD)
Entity Type:Individual
Prefix:DR
First Name:BURTON
Middle Name:H
Last Name:POLLOCK
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 1:339 6TH AVE
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-2517
Mailing Address - Country:US
Mailing Address - Phone:412-560-8888
Mailing Address - Fax:
Practice Address - Street 1:339 6TH AVE
Practice Address - Street 2:4TH FLOOR
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-2517
Practice Address - Country:US
Practice Address - Phone:412-560-8888
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD028759L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA017095E8JMedicare ID - Type Unspecified
PAC27238Medicare UPIN