MEDICARE: CHARLES W. CLINE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	MD031665E	PA

General Provider Information

NPI Number	:	1033114749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES W. CLINE MD

Provider Business Mailing Address
First Line	:	1200 BROOKS LANE
Second Line	:	170
City	:	JEFFERSON HILLS
State	:	PA
Zip	:	15025-3749
Country	:	US
Telephone Number	:	412-469-7110
Fax Number	:	412-469-8965

Provider Business Practice Location Address
First Line	:	1200 BROOKS LANE
Second Line	:	170
City	:	JEFFERSON HILLS
State	:	PA
Zip	:	15025-3749
Country	:	US
Telephone Number	:	412-469-7110
Fax Number	:	412-469-8965

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	10/05/2020

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Directions to “ CHARLES W. CLINE MD” Practice Location

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