Provider Demographics
NPI:1891139457
Name:FOURCADE, ELIZABETH WOLF (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:WOLF
Last Name:FOURCADE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 ALLEGHENY CTR., EAST COMMONS PROF BLDG, 8TH FL.
Mailing Address - Street 2:DEPT. OF PSYCHIATRY, ALLEGHENY CLINIC
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212
Mailing Address - Country:US
Mailing Address - Phone:412-330-4312
Mailing Address - Fax:412-330-4377
Practice Address - Street 1:4 ALLEGHENY CTR BLDG 8TH
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-5255
Practice Address - Country:US
Practice Address - Phone:412-330-4312
Practice Address - Fax:412-330-4377
Is Sole Proprietor?:No
Enumeration Date:2013-04-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4568912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
14050483OtherCAQH
PA103328855Medicaid