Provider Demographics
NPI:1700824943
Name:AL-ISSA, FERAS TAWFIQ (MD)
Entity Type:Individual
Prefix:
First Name:FERAS
Middle Name:TAWFIQ
Last Name:AL-ISSA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:200 LOTHROP ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2536
Mailing Address - Country:US
Mailing Address - Phone:412-692-5180
Mailing Address - Fax:412-692-7355
Practice Address - Street 1:200 LOTHROP ST
Practice Address - Street 2:FORBES TOWER SUITE 9055
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2546
Practice Address - Country:US
Practice Address - Phone:412-647-3087
Practice Address - Fax:412-647-4486
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4255042080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAI51226Medicare UPIN