Dv Professional Group Pllc | |
4307 Glades Dr Allison Park PA 15101-1521 | |
(412) 577-8622 | |
Not Available |
Full Name | Dv Professional Group Pllc |
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Speciality | Internal Medicine |
Location | 4307 Glades Dr, Allison Park, Pennsylvania |
Authorized Official Name and Position | Athan Georgiades (PRESIDENT) |
Authorized Official Contact | 4126832267 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Dv Professional Group Pllc 4307 Glades Dr Allison Park PA 15101-1521 Ph: (412) 577-8622 | Dv Professional Group Pllc 4307 Glades Dr Allison Park PA 15101-1521 Ph: (412) 577-8622 |
NPI Number | 1114774577 |
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Provider Enumeration Date | 05/03/2024 |
Last Update Date | 05/03/2024 |
Medicare PECOS PAC ID | 9638613425 |
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Medicare Enrollment ID | O20240703003239 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114774577 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Dwight Earl Heron |
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Provider Type | Practitioner - Radiation Oncology |
Provider Identifiers | NPI Number: 1578536397 PECOS PAC ID: 1153315023 Enrollment ID: I20050525000651 |
Provider Name | Jason P Tomsic |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1578766200 PECOS PAC ID: 2062564149 Enrollment ID: I20090721000497 |
Provider Name | Athan H Georgiades |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1972518363 PECOS PAC ID: 8325229081 Enrollment ID: I20110301000366 |
Provider Name | Casey Kapis |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1154771251 PECOS PAC ID: 5294014585 Enrollment ID: I20161109000372 |
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