Provider Demographics
NPI:1336124916
Name:LE, THU (MD)
Entity Type:Individual
Prefix:
First Name:THU
Middle Name:
Last Name:LE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4735 CLAIRTON BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-2115
Mailing Address - Country:US
Mailing Address - Phone:412-885-5400
Mailing Address - Fax:412-885-1773
Practice Address - Street 1:4735 CLAIRTON BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236-2115
Practice Address - Country:US
Practice Address - Phone:412-885-5400
Practice Address - Fax:412-885-1773
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2017-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD421191208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1013242760001Medicaid
PA092747HYHMedicare ID - Type Unspecified
H19946Medicare UPIN