| Rudolph Antoncic Iii, M.d., P.c. | |
|
5301 Walnut St Mckeesport PA 15132-6327 | |
| (412) 751-4400 | |
| (412) 751-4881 |
| Full Name | Rudolph Antoncic Iii, M.d., P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 5301 Walnut St, Mckeesport, Pennsylvania |
| Authorized Official Name and Position | Rudolph Andrew Antoncic (OWNER) |
| Authorized Official Contact | 4127543770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rudolph Antoncic Iii, M.d., P.c. 2255 Greenock Buena Vista Rd Mckeesport PA 15135-3007 Ph: (412) 754-3770 | Rudolph Antoncic Iii, M.d., P.c. 5301 Walnut St Mckeesport PA 15132-6327 Ph: (412) 751-4400 |
| NPI Number | 1225236722 |
|---|---|
| Provider Enumeration Date | 07/05/2007 |
| Last Update Date | 10/25/2007 |
| Medicare PECOS PAC ID | 0547207029 |
|---|---|
| Medicare Enrollment ID | O20050415000492 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225236722 | NPI | - | NPPES |
| 1385401 | Other | PA | HIGHMARK BLUE SHIELD |
| 1521997 | Other | GATEWAY HEALTH PLAN | |
| 308210 | Other | UPMC HEALTH PLAN | |
| 0019003720001 | Medicaid | PA | |
| 75640 | Other | AETNA | |
| 262531 | Other | HEALTH AMERICA | |
| 125036 | Other | UNISON HEALTH PLAN | |
| 2074615000 | Other | INDEPENDENCE BLUE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD418006 (Pennsylvania) | Primary |
| Provider Name | Rudolph Andrew Antoncic |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871667907 PECOS PAC ID: 1951400605 Enrollment ID: I20070621000418 |
White Oak Medical Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1949 Lincoln Way, Mckeesport, PA 15131 Phone: 412-672-6800 | |
R Curtis Waligura D.o. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2709 Oneil Blvd, Mckeesport, PA 15132 Phone: 412-678-7717 Fax: 412-678-3923 | |
Lawrence L. Lyons, Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1801 Lincoln Way, Mckeesport, PA 15131 Phone: 412-672-8311 | |
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