Provider Demographics
NPI:1700232709
Name:KOCHIK, MICHAEL ANDREW (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ANDREW
Last Name:KOCHIK
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 1:5200 CENTRE AVE STE 312
Mailing Address - Street 2:
Mailing Address - City:SHADYSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:15232-1302
Mailing Address - Country:US
Mailing Address - Phone:412-621-7777
Mailing Address - Fax:
Practice Address - Street 1:5200 CENTRE AVE STE 312
Practice Address - Street 2:
Practice Address - City:SHADYSIDE
Practice Address - State:PA
Practice Address - Zip Code:15232-1302
Practice Address - Country:US
Practice Address - Phone:412-621-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-09
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY311946207RG0100X
PAOS023206207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology