Provider Demographics
NPI:1932119195
Name:VUJEVICH DERMATOLOGY ASSOCIATES PC
Entity Type:Organization
Organization Name:VUJEVICH DERMATOLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:VUJEVICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-429-2570
Mailing Address - Street 1:100 N WREN DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1248
Mailing Address - Country:US
Mailing Address - Phone:412-429-2570
Mailing Address - Fax:412-429-2972
Practice Address - Street 1:100 N WREN DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1248
Practice Address - Country:US
Practice Address - Phone:412-429-2570
Practice Address - Fax:412-429-2972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029853L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006084870003Medicaid
PA767688OtherHIGHMARK
PA103669OtherUPMC
PACA5086OtherRAILROAD MEDICARE
PA767688Medicare ID - Type Unspecified
PA767688OtherHIGHMARK