Healthcare Provider Details

I. General information

NPI: 1083705883
Provider Name (Legal Business Name): GEORGE ALAN YEASTED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 BOWER HILL RD
PITTSBURGH PA
15243
US

IV. Provider business mailing address

1369 WASHINGTON RD
PITTSBURGH PA
15228
US

V. Phone/Fax

Practice location:
  • Phone: 412-344-6600
  • Fax: 412-572-6933
Mailing address:
  • Phone: 412-561-0820
  • Fax: 412-561-0785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD016944E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: