Provider Demographics
NPI:1801865001
Name:MINTEER, JEFFREY F (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:F
Last Name:MINTEER
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 1:95 LEONARD AVE
Mailing Address - Street 2:BLDG 2
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-3368
Mailing Address - Country:US
Mailing Address - Phone:724-223-3100
Mailing Address - Fax:724-223-3353
Practice Address - Street 1:95 LEONARD AVE
Practice Address - Street 2:BLDG 2
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-3368
Practice Address - Country:US
Practice Address - Phone:724-223-3100
Practice Address - Fax:724-223-3353
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2013-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD021855E207Q00000X, 207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
63906OtherUNISON
000408167OtherHIGHMARK
100718OtherUPMC
PA0010196240002Medicaid
P000414OtherGATEWAY
P000414OtherGATEWAY
B41324Medicare UPIN
63906OtherUNISON