Provider Demographics
NPI:1679543193
Name:BISCHOF, LEE (DO)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:
Last Name:BISCHOF
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 OXFORD DR
Mailing Address - Street 2:STE 303
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-1841
Mailing Address - Country:US
Mailing Address - Phone:800-394-4445
Mailing Address - Fax:706-955-0743
Practice Address - Street 1:1000 BOWER HILL RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1873
Practice Address - Country:US
Practice Address - Phone:412-344-6600
Practice Address - Fax:412-572-6747
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS012127207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018842320001Medicaid
PA055393FG3Medicare ID - Type Unspecified
PA055393Medicare PIN