Provider Demographics
NPI:1548227762
Name:SPECA, MICHAEL J (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:SPECA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:701 TECHNOLOGY DR STE 150
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-9531
Mailing Address - Country:US
Mailing Address - Phone:412-531-2902
Mailing Address - Fax:412-531-2948
Practice Address - Street 1:8050 NOBLESTOWN RD
Practice Address - Street 2:
Practice Address - City:MC DONALD
Practice Address - State:PA
Practice Address - Zip Code:15057-2285
Practice Address - Country:US
Practice Address - Phone:724-926-3320
Practice Address - Fax:724-926-4205
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS010704L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA218981OtherUPMC
PA1374814OtherBLUE SHIELD
PA0018981850003Medicaid
OH2317246Medicaid
PA218981OtherUPMC
P00207400Medicare PIN
PA044438SXMMedicare PIN
OH2317246Medicaid