Provider Demographics
NPI:1407233620
Name:LEVESQUE, RENEE (MD)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:LEVESQUE
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:SHADYSIDE MEDICAL BLDG, 5200 CENTRE AVE
Mailing Address - Street 2:SUITE 715
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232
Mailing Address - Country:US
Mailing Address - Phone:412-623-2025
Mailing Address - Fax:
Practice Address - Street 1:SHADYSIDE MEDICAL BUILDING, 5200 CENTRE AVE
Practice Address - Street 2:SUITE 715
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232
Practice Address - Country:US
Practice Address - Phone:412-623-2025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-27
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD474291208G00000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)