Provider Demographics
NPI:1821068206
Name:EDDE, PIERRE K (MD)
Entity Type:Individual
Prefix:
First Name:PIERRE
Middle Name:K
Last Name:EDDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:PIERRE
Other - Middle Name:
Other - Last Name:KHOURY EDDE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:355 SARATOGA DR
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-5645
Mailing Address - Country:US
Mailing Address - Phone:724-434-1666
Mailing Address - Fax:
Practice Address - Street 1:205 EASY ST
Practice Address - Street 2:PROFESSIONAL PLAZA I, SUITE 108
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-3128
Practice Address - Country:US
Practice Address - Phone:724-439-1800
Practice Address - Fax:724-439-0799
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD419871207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA319226OtherUPMC
PA1530428OtherGATEWAY PIN
PA1460337OtherBLUE SHIELD PIN
PA0019171280007Medicaid
PA164559OtherUNISON (MEDPLUS)
PA1530428OtherGATEWAY PIN