Provider Demographics
NPI:1821291238
Name:PAGNOTTO, MICHAEL R (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:R
Last Name:PAGNOTTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5900 CORPORATE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-7005
Mailing Address - Country:US
Mailing Address - Phone:412-369-4000
Mailing Address - Fax:412-369-7667
Practice Address - Street 1:5900 CORPORATE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-7005
Practice Address - Country:US
Practice Address - Phone:412-369-4000
Practice Address - Fax:412-369-7667
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT182770207X00000X
MN53435207X00000X
MN104889207X00000X
PAMD436148207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNENROLLEDMedicaid
MN200002944Medicare PIN