Provider Demographics
NPI:1497936587
Name:MASSART, MYLYNDA BERYL (MD)
Entity Type:Individual
Prefix:DR
First Name:MYLYNDA
Middle Name:BERYL
Last Name:MASSART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MYLYNDA
Other - Middle Name:BERYL
Other - Last Name:SCHLESINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:373 BURROWS ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2201
Mailing Address - Country:US
Mailing Address - Phone:412-383-1550
Mailing Address - Fax:412-383-1400
Practice Address - Street 1:373 BURROWS ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2201
Practice Address - Country:US
Practice Address - Phone:412-383-1550
Practice Address - Fax:412-383-1400
Is Sole Proprietor?:No
Enumeration Date:2007-11-17
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-10700207Q00000X
ORLL17171207Q00000X
PAMD453195207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA374464Medicare PIN