Provider Demographics
NPI:1467454983
Name:PETURSSON, SIGURDUR R (MD)
Entity Type:Individual
Prefix:DR
First Name:SIGURDUR
Middle Name:R
Last Name:PETURSSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:247 MOREWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-1861
Mailing Address - Country:US
Mailing Address - Phone:412-622-0290
Mailing Address - Fax:412-681-7605
Practice Address - Street 1:160 HOLLYWOOD DR FL 2
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-5600
Practice Address - Country:US
Practice Address - Phone:724-282-6175
Practice Address - Fax:724-482-1115
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD016623E207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000965499Medicaid
PA155823SDBMedicare PIN
PA000965499Medicaid