Healthcare Provider Details

I. General information

NPI: 1548843568
Provider Name (Legal Business Name): MARGOT PENN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2021
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3824 NORTHERN PIKE STE 200
MONROEVILLE PA
15146-2173
US

IV. Provider business mailing address

4 ALLEGHENY CTR FL 7T
PITTSBURGH PA
15212-5255
US

V. Phone/Fax

Practice location:
  • Phone: 412-380-2800
  • Fax:
Mailing address:
  • Phone: 412-330-6318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS024029
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberOS024029
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: