Provider Demographics
NPI:1801856034
Name:MARCUCCI, JAMES WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:WILLIAM
Last Name:MARCUCCI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1000 BOWER HILL ROAD
Mailing Address - Street 2:ATTN ST CLAIR HOSPITAL - AFFILIATE BILLING - PAMALYN
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1873
Mailing Address - Country:US
Mailing Address - Phone:412-942-2548
Mailing Address - Fax:412-429-8067
Practice Address - Street 1:363 VANADIUM RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1497
Practice Address - Country:US
Practice Address - Phone:412-429-8840
Practice Address - Fax:412-429-8067
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD018552E207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008103230001Medicaid
PA005048LKAMedicare ID - Type Unspecified
PA0008103230001Medicaid