Provider Demographics
NPI:1265409841
Name:MESSINA, MICHAEL PETER (DO)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:PETER
Last Name:MESSINA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SHENANGO AVE
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-1503
Mailing Address - Country:US
Mailing Address - Phone:724-342-4052
Mailing Address - Fax:724-342-4053
Practice Address - Street 1:63 PITT ST
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146-2102
Practice Address - Country:US
Practice Address - Phone:724-981-1940
Practice Address - Fax:724-981-2825
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS005120L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009125390002Medicaid
OH0692693Medicaid
PA0009125390002Medicaid