Provider Demographics
NPI:1245336072
Name:FAYETTE LUNG AND SLEEP CENTER, PC
Entity type:Organization
Organization Name:FAYETTE LUNG AND SLEEP CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PIERRE
Authorized Official - Middle Name:K
Authorized Official - Last Name:EDDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:723-439-1800
Mailing Address - Street 1:205 EASY ST
Mailing Address - Street 2:PROFESSIONAL PLAZA I, SUITE 108
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-3128
Mailing Address - Country:US
Mailing Address - Phone:724-439-1800
Mailing Address - Fax:724-439-0799
Practice Address - Street 1:205 EASY ST
Practice Address - Street 2:PROFESSIONAL PLAZA I, SUITE 108
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-3128
Practice Address - Country:US
Practice Address - Phone:724-439-1800
Practice Address - Fax:724-439-0799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1012512500001Medicaid
PAE001OtherGATEWAY
PAV0855BOtherUPMC
PAE001OtherGATEWAY
PA090985Medicare PIN