Provider Demographics
NPI:1750357489
Name:GEORGE, JOSE P (MD, PHD, CMD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:P
Last Name:GEORGE
Suffix:
Gender:M
Credentials:MD, PHD, CMD
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Mailing Address - Street 1:4655 WILLIAM FLYNN HWY
Mailing Address - Street 2:SUITE 125A, COVENTRY SQAURE
Mailing Address - City:ALLISON PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15101-2243
Mailing Address - Country:US
Mailing Address - Phone:412-487-4888
Mailing Address - Fax:412-487-2226
Practice Address - Street 1:4655 WILLIAM FLYNN HWY
Practice Address - Street 2:SUITE 125A
Practice Address - City:ALLISON PARK
Practice Address - State:PA
Practice Address - Zip Code:15101-2243
Practice Address - Country:US
Practice Address - Phone:412-487-4888
Practice Address - Fax:412-487-2226
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2010-06-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD039908L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA506954PD9Medicare PIN
PAC34726Medicare UPIN