Provider Demographics
NPI:1598764458
Name:BABICH, MICHAEL MATTHEW (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:MATTHEW
Last Name:BABICH
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 1:1307 FEDERAL ST STE B100
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4761
Mailing Address - Country:US
Mailing Address - Phone:412-359-8900
Mailing Address - Fax:412-359-8977
Practice Address - Street 1:1307 FEDERAL ST STE B100
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4761
Practice Address - Country:US
Practice Address - Phone:412-359-8900
Practice Address - Fax:412-359-8977
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD062801L207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001663438Medicaid
10922427OtherCAQH
PACG2279Medicare PIN
PAG60015Medicare UPIN
PA0016634380010Medicaid
PA100013332Medicare PIN
PACG2176Medicare PIN
PACG2169Medicare PIN
PA100013336Medicare PIN
PA002223NHUMedicare PIN
PA100013334Medicare PIN