Healthcare Provider Details

I. General information

NPI: 1306077227
Provider Name (Legal Business Name): MIGUEL A. MARRERO, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2009
Last Update Date: 07/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4955 STEUBENVILLE PIKE STE 364
PITTSBURGH PA
15205-9619
US

IV. Provider business mailing address

4955 STEUBENVILLE PIKE STE 364
PITTSBURGH PA
15205-9619
US

V. Phone/Fax

Practice location:
  • Phone: 412-494-7560
  • Fax: 412-494-7564
Mailing address:
  • Phone: 412-494-7560
  • Fax: 412-494-7564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberMD046545L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberMD046545L
License Number StatePA

VIII. Authorized Official

Name: DR. MIGUEL A MARRERO
Title or Position: PRESIDENT
Credential: MD
Phone: 412-494-7560