Provider Demographics
NPI:1467499079
Name:STIEG, PHILIP DENNISON (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:DENNISON
Last Name:STIEG
Suffix:
Gender:M
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:PO BOX 347358
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15251-4358
Mailing Address - Country:US
Mailing Address - Phone:717-270-7645
Mailing Address - Fax:717-270-7639
Practice Address - Street 1:FOURTH & WALNUT STREETS
Practice Address - Street 2:RADIOLOGY DEPARTMENT
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-1281
Practice Address - Country:US
Practice Address - Phone:717-270-7645
Practice Address - Fax:717-270-7639
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037554E2085R0202X, 2085N0700X, 2085N0904X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Not Answered2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Not Answered2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001154576Medicaid
A41321Medicare UPIN
PA001154576Medicaid