Provider Demographics
NPI:1417054503
Name:GIGNAC, MARC R (MD)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:R
Last Name:GIGNAC
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1307 FEDERAL ST
Mailing Address - Street 2:STE 300
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4769
Mailing Address - Country:US
Mailing Address - Phone:412-281-1757
Mailing Address - Fax:412-281-7274
Practice Address - Street 1:1307 FEDERAL ST
Practice Address - Street 2:STE 300
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4769
Practice Address - Country:US
Practice Address - Phone:412-281-1757
Practice Address - Fax:412-281-7274
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2014-04-18
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Provider Licenses
StateLicense IDTaxonomies
PAMD056060L208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016553100006Medicaid
PA0016553100006Medicaid
PA000125Medicare PIN