Provider Demographics
NPI:1487628780
Name:ZIDAR, BERNARD L (MD)
Entity Type:Individual
Prefix:
First Name:BERNARD
Middle Name:L
Last Name:ZIDAR
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 1:200 DELAFIELD RD
Mailing Address - Street 2:SUITE 3050
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15215-3205
Mailing Address - Country:US
Mailing Address - Phone:412-781-3744
Mailing Address - Fax:412-781-3793
Practice Address - Street 1:200 DELAFIELD RD
Practice Address - Street 2:SUITE 3050
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15215-3205
Practice Address - Country:US
Practice Address - Phone:412-781-3744
Practice Address - Fax:412-781-3793
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD013720E207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007404800006Medicaid
PA166122OtherHIGHMARK BLUE SHIELD
PA10766441OtherCAQH
PAB40504Medicare UPIN
PA166122F6VMedicare PIN
PA110042467Medicare PIN