Provider Demographics
NPI:1134267768
Name:ADRIENNE M YOUNG MD LLC
Entity type:Organization
Organization Name:ADRIENNE M YOUNG MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-771-0555
Mailing Address - Street 1:PO BOX 93
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-0093
Mailing Address - Country:US
Mailing Address - Phone:412-771-0555
Mailing Address - Fax:412-771-0455
Practice Address - Street 1:27 HECKEL RD
Practice Address - Street 2:SUITE 205 MEDICAL OFFICE BUILDING
Practice Address - City:MC KEES ROCKS
Practice Address - State:PA
Practice Address - Zip Code:15136-1616
Practice Address - Country:US
Practice Address - Phone:412-771-0555
Practice Address - Fax:412-771-0455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-04
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042043E207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty