Healthcare Provider Details

I. General information

NPI: 1528032323
Provider Name (Legal Business Name): GEORGE DANIEL MARTICH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2006
Last Update Date: 02/10/2022
Certification Date: 02/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 TERRACE STREET A1305 SCAIFE HALL
PITTSBURGH PA
15261-0001
US

IV. Provider business mailing address

613 LINCOLN RD
BRADFORDWOODS PA
15015-1223
US

V. Phone/Fax

Practice location:
  • Phone: 412-647-2808
  • Fax:
Mailing address:
  • Phone: 412-721-0441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMD042024L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD042024L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: