Provider Demographics
NPI:1710984000
Name:WHITSEL, AMY I (MD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:I
Last Name:WHITSEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4815 LIBERTY AVENUE
Mailing Address - Street 2:SUITE GR59
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2156
Mailing Address - Country:US
Mailing Address - Phone:412-578-3951
Mailing Address - Fax:412-578-1587
Practice Address - Street 1:4815 LIBERTY AVENUE
Practice Address - Street 2:SUITE GR59
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2156
Practice Address - Country:US
Practice Address - Phone:412-578-3951
Practice Address - Fax:412-578-1587
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD047092L207VM0101X, 207VM0101X
IN01053131A207VM0101X
WI54844207VM0101X
KY41306207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
11606263OtherCAQH
PA101640516Medicaid
G52487Medicare UPIN
00000054456OtherANTHEM
KY50017001OtherPASSPORT PCP
KY7100012900Medicaid
IN200881550Medicaid
KY50017002OtherPASSPORT SPECIALTY
PA382359Medicare PIN
KY0722541Medicare PIN
IN000000764636OtherANTHEM
KY000000542979OtherANTHEM
KY50017003OtherPASSPORT SPECIALTY
KY0979713Medicare PIN