Provider Demographics
NPI:1396939328
Name:HICKEY, GAVIN WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:GAVIN
Middle Name:WILLIAM
Last Name:HICKEY
Suffix:
Gender:M
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:UPMC HEART AND VASCULAR INSTITUTE
Mailing Address - Street 2:200 LOTHROP STREET
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:UPMC HEART AND VASCULAR INSTITUTE
Practice Address - Street 2:200 LOTHROP STREET, 5B
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2536
Practice Address - Country:US
Practice Address - Phone:412-647-2345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-03
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD436803207RA0001X, 207R00000X
PAMD463803207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease