Provider Demographics
NPI:1487670022
Name:JUREWICZ, WITOLD R (MD)
Entity Type:Individual
Prefix:DR
First Name:WITOLD
Middle Name:R
Last Name:JUREWICZ
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 LOTHROP ST
Mailing Address - Street 2:FORBES TOWER, SUITE 9055
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2536
Mailing Address - Country:US
Mailing Address - Phone:412-647-3087
Mailing Address - Fax:412-647-4486
Practice Address - Street 1:3021 JACKS RUN RD
Practice Address - Street 2:
Practice Address - City:WHITE OAK
Practice Address - State:PA
Practice Address - Zip Code:15131-2523
Practice Address - Country:US
Practice Address - Phone:412-267-5969
Practice Address - Fax:412-267-5970
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD429817207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00960665Medicare PIN
PA1017258650003Medicare PIN
PA104860Medicare PIN
PAI65326Medicare UPIN