Provider Demographics
NPI:1457484560
Name:PAWELSKI, LISA A (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:A
Last Name:PAWELSKI
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 1:3424 WILLIAM PENN HIGHWAY
Mailing Address - Street 2:PENN CENTER EAST BLDG 2 SUITE 221
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-5411
Mailing Address - Country:US
Mailing Address - Phone:412-824-9600
Mailing Address - Fax:
Practice Address - Street 1:3424 WILLIAM PENN HIGHWAY
Practice Address - Street 2:PENN CENTER EAST BLDG 2 SUITE 221
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-5411
Practice Address - Country:US
Practice Address - Phone:412-824-9600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA047262L207N00000X, 207NS0135X, 207NP0225X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA058524OtherHIGHMARK BCBS
PA058524MBJMedicare ID - Type Unspecified
PAF34219Medicare UPIN