Provider Demographics
NPI:1770569808
Name:HUNTER, GEORGE R (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:R
Last Name:HUNTER
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 1:520 JEFFERSON AVE STE 505
Mailing Address - Street 2:
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-2538
Mailing Address - Country:US
Mailing Address - Phone:724-527-1145
Mailing Address - Fax:724-527-3535
Practice Address - Street 1:520 JEFFERSON AVE STE 505
Practice Address - Street 2:
Practice Address - City:JEANNETTE
Practice Address - State:PA
Practice Address - Zip Code:15644-2538
Practice Address - Country:US
Practice Address - Phone:724-527-1145
Practice Address - Fax:724-527-3535
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD0919468E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1022672180001Medicaid
C29010Medicare UPIN
072554Medicare ID - Type Unspecified