Provider Demographics
NPI:1912908419
Name:PARDA, DAVID STEPHEN (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:STEPHEN
Last Name:PARDA
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 1:320 E NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4756
Mailing Address - Country:US
Mailing Address - Phone:412-359-3400
Mailing Address - Fax:412-359-3171
Practice Address - Street 1:320 E NORTH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4756
Practice Address - Country:US
Practice Address - Phone:412-359-3400
Practice Address - Fax:412-359-3171
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2020-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD066001L2085R0203X, 2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV6000852000Medicaid
OH2110441Medicaid
PA001702910Medicaid
PA001702910Medicaid
PA001702910Medicaid
PA920005972Medicare PIN
OH2110441Medicaid
WV6000852000Medicaid