Provider Demographics
NPI:1780643650
Name:PINEVICH, ANTHONY J (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:J
Last Name:PINEVICH
Suffix:
Gender:
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:PO BOX 321
Mailing Address - Street 2:
Mailing Address - City:INGOMAR
Mailing Address - State:PA
Mailing Address - Zip Code:15127-0321
Mailing Address - Country:US
Mailing Address - Phone:412-478-5360
Mailing Address - Fax:724-522-5142
Practice Address - Street 1:1400 LOCUST ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-5114
Practice Address - Country:US
Practice Address - Phone:412-478-5360
Practice Address - Fax:724-522-5142
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037574E174400000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA107781OtherMEDICARE GROUP PTAN
PA1399243OtherAETNA
PA674509OtherBCBS
PAP00385822OtherRR MEDICARE
PA1004928OtherGATEWAY
PA000000190035OtherUNISON
PA001244898Medicaid
PA1952062OtherCIGNA
PA250156OtherUPMC
PA1004928OtherGATEWAY
PA674509V5PMedicare PIN