Provider Demographics
NPI:1790776979
Name:GARBUTT, RONALD G (M D)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:G
Last Name:GARBUTT
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 S 9TH ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-1266
Mailing Address - Country:US
Mailing Address - Phone:877-637-2924
Mailing Address - Fax:
Practice Address - Street 1:330 S 9TH ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-1266
Practice Address - Country:US
Practice Address - Phone:877-637-2924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD058447L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001473219Medicaid
PA723119OtherHIGHMARK
F60555Medicare UPIN
PA823119Medicare ID - Type Unspecified
PA723119OtherHIGHMARK