Provider Demographics
NPI:1720187693
Name:KRIVINKO, DENNIS MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:MICHAEL
Last Name:KRIVINKO
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 1:9000 BROOKTREE ROAD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9288
Mailing Address - Country:US
Mailing Address - Phone:724-934-1600
Mailing Address - Fax:724-934-1620
Practice Address - Street 1:9000 BROOKTREE ROAD
Practice Address - Street 2:SUITE 400
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9288
Practice Address - Country:US
Practice Address - Phone:724-934-1600
Practice Address - Fax:724-934-1620
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD020948-E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100803OtherHIGHMARK
PA229556OtherHEALTHAMERICA
PA77263OtherUNITEDHEALTHCARE
PA204665OtherUPMC
PA77263OtherAETNA
PA77263OtherUNITEDHEALTHCARE
PAB36341Medicare UPIN