Provider Demographics
NPI:1467462507
Name:LEDVIN, VERONICA (MD)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:LEDVIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VERONIKA
Other - Middle Name:
Other - Last Name:LEDVIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:12351 PERRY HWY
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-8344
Mailing Address - Country:US
Mailing Address - Phone:412-359-3030
Mailing Address - Fax:412-359-3060
Practice Address - Street 1:100 HOSPITAL AVE
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-1440
Practice Address - Country:US
Practice Address - Phone:814-371-2200
Practice Address - Fax:814-372-2568
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYTL6501207R00000X
PAMD427586208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101894124 0002OtherPROVIDER NUMBER
PA101894121 0001Medicaid
PA101894121 0001Medicaid
PA278171UFWMedicare PIN
PA111752XS2Medicare PIN
PA111752ZCHMMedicare PIN