Provider Demographics
NPI:1710974910
Name:BIDULA, MAUREEN M (MD)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:M
Last Name:BIDULA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:400 PENN CENTER BLVD
Mailing Address - Street 2:SUITE 555
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-5610
Mailing Address - Country:US
Mailing Address - Phone:412-829-7288
Mailing Address - Fax:412-829-1310
Practice Address - Street 1:2570 HAYMAKER RD
Practice Address - Street 2:DEPARTMENT OF RADIOLOGY
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3513
Practice Address - Country:US
Practice Address - Phone:412-858-2343
Practice Address - Fax:412-373-0861
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD024341E2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010295130020Medicaid
PABI467455OtherHIGHMARK
PA0013685000OtherINDEPENDENCE BLUE CROSS
PABI467455OtherHIGHMARK
PA0010295130020Medicaid
PABI467455OtherHIGHMARK