Provider Demographics
NPI:1821084914
Name:STYPULA, RICHARD W JR (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:W
Last Name:STYPULA
Suffix:JR
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 1:4800 FRIENDSHIP AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-1722
Mailing Address - Country:US
Mailing Address - Phone:412-578-5323
Mailing Address - Fax:412-605-6425
Practice Address - Street 1:4800 FRIENDSHIP AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1722
Practice Address - Country:US
Practice Address - Phone:412-578-5323
Practice Address - Fax:412-605-6425
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD022941E207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0765926Medicaid
PA0008506790008Medicaid
WV3810001781Medicaid
PAP00346754OtherRAILROAD MEDICARE
PA0008506790019Medicaid
WV3810001781Medicaid
PAP00346754OtherRAILROAD MEDICARE
PA188119U31Medicare PIN