Provider Demographics
NPI:1528032323
Name:MARTICH, GEORGE DANIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:DANIEL
Last Name:MARTICH
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 1:613 LINCOLN RD
Mailing Address - Street 2:
Mailing Address - City:BRADFORDWOODS
Mailing Address - State:PA
Mailing Address - Zip Code:15015-1223
Mailing Address - Country:US
Mailing Address - Phone:412-721-0441
Mailing Address - Fax:
Practice Address - Street 1:3550 TERRACE STREET
Practice Address - Street 2:A1305 SCAIFE HALL
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15261-0001
Practice Address - Country:US
Practice Address - Phone:412-647-2808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042024L207RC0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001288767Medicaid
PAF29411Medicare UPIN
PA725880H88Medicare ID - Type Unspecified