Provider Demographics
NPI:1811993207
Name:JEWART, BRIAN H (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:H
Last Name:JEWART
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:PO BOX 644214
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15264-4214
Mailing Address - Country:US
Mailing Address - Phone:412-653-3080
Mailing Address - Fax:412-650-8963
Practice Address - Street 1:9970 MOUNTAIN VIEW DR
Practice Address - Street 2:SUITE 200
Practice Address - City:WEST MIFFLIN
Practice Address - State:PA
Practice Address - Zip Code:15122-2474
Practice Address - Country:US
Practice Address - Phone:412-655-4764
Practice Address - Fax:412-653-3580
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD045592L207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0000700341OtherAMERIHEALTH ADMINISTRATOR
PA0015779840009Medicaid
PA1509303OtherGATEWAY HEALTH PLAN
PA13356OtherELDER HEALTH PLAN
PA31202OtherADVANTRA/HEALTH AMERICA
PA251100359004OtherPGBA TRICARE
PA251100359004OtherTRICARE PGBA
PA517317OtherAETNA
PA200700OtherUPMC HEALTH PLAN
PA700341OtherHIGHMARK BS
PA0015779840001Medicaid
PAJE700341OtherUMWA
PA000000065444OtherUNISON HEALTH PLAN
PA251100359004OtherTRICARE PGBA
PA251100359004OtherPGBA TRICARE
PA700341EVXMedicare PIN