Provider Demographics
NPI:1568853968
Name:AVDIC, EMA (DO)
Entity Type:Individual
Prefix:
First Name:EMA
Middle Name:
Last Name:AVDIC
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:EMMA
Other - Middle Name:
Other - Last Name:AVDIC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PREFERRED SPELLING
Mailing Address - Street 1:320 E NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4756
Mailing Address - Country:US
Mailing Address - Phone:412-359-3751
Mailing Address - Fax:
Practice Address - Street 1:320 E NORTH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4756
Practice Address - Country:US
Practice Address - Phone:412-359-3131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-07
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT019061207R00000X
PAOS022024207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine