Provider Demographics
NPI:1952192528
Name:MCDIVITT, MARIAH J
Entity type:Individual
Prefix:
First Name:MARIAH
Middle Name:J
Last Name:MCDIVITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5796 MIDDLE RUN RD NW
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44622-7657
Mailing Address - Country:US
Mailing Address - Phone:412-304-9049
Mailing Address - Fax:
Practice Address - Street 1:5796 MIDDLE RUN RD NW
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-7657
Practice Address - Country:US
Practice Address - Phone:412-304-9049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide