Provider Demographics
NPI:1265477269
Name:WAHAL, GEORGE
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:WAHAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6530 ROUTE 22
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DELMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15626-2414
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6530 ROUTE 22
Practice Address - Street 2:SUITE 100
Practice Address - City:DELMONT
Practice Address - State:PA
Practice Address - Zip Code:15626-2414
Practice Address - Country:US
Practice Address - Phone:724-468-6477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD024274E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P000593OtherGATEWAY HEALTH PLAN
PA001174953Medicaid
197442OtherBLUE SHIELD
4021626OtherAETNA
100678OtherUPMC HEALTH PLAN
110079462OtherRAILROAD MEDICARE
110079462OtherRAILROAD MEDICARE
4021626OtherAETNA
PA197442Medicare PIN