Healthcare Provider Details
I. General information
NPI: 1487628780
Provider Name (Legal Business Name): BERNARD L ZIDAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/14/2006
Last Update Date: 06/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 DELAFIELD RD SUITE 3050
PITTSBURGH PA
15215-3205
US
IV. Provider business mailing address
200 DELAFIELD RD SUITE 3050
PITTSBURGH PA
15215-3205
US
V. Phone/Fax
- Phone: 412-781-3744
- Fax: 412-781-3793
- Phone: 412-781-3744
- Fax: 412-781-3793
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | MD013720E |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: