Provider Demographics
NPI:1700995248
Name:PIATOK, DAVID J (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:PIATOK
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 1:1 GUTHRIE SQ
Mailing Address - Street 2:
Mailing Address - City:SAYRE
Mailing Address - State:PA
Mailing Address - Zip Code:18840-1625
Mailing Address - Country:US
Mailing Address - Phone:570-888-5858
Mailing Address - Fax:
Practice Address - Street 1:105 DESMOND ST
Practice Address - Street 2:
Practice Address - City:SAYRE
Practice Address - State:PA
Practice Address - Zip Code:18840-2001
Practice Address - Country:US
Practice Address - Phone:570-887-2832
Practice Address - Fax:570-887-3035
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD045014L207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0155395502OtherAMERICHOICE
PA2303074000OtherAMERIHEALTH
PA30020814OtherKEYSTONE MERCY
PA0135480000OtherKEYSTONE HEALTH CARE EAST
PA0135480000OtherINDEPENDENCE BLUE CROSS
PA3305525OtherUNITED HEALTHCARE
PAP2930846OtherOXFORD HEALTH PLAN
PA141911253OtherDEVON
PA431364OtherHIGHMARK
PA1624792OtherHIGHMARK GROUP PROVIDER #
PA2303074000OtherINDEPENDENCE BLUE CROSS
PA3582485OtherAETNA
PA5691070OtherAETNA
PA0135480000OtherAMERIHEALTH
PA2303074000OtherKEYSTONE HEALTH CARE EAST
PA431364OtherINDEPENDENCE BLUE CROSS
PA1624792OtherINDEPENDENCE BLUE CROSS
PA2303074000OtherKEYSTONE HEALTH CARE EAST
PAF45738Medicare UPIN