Healthcare Provider Details

I. General information

NPI: 1144274887
Provider Name (Legal Business Name): DAVID MARTIN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 02/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4727 FRIENDSHIP AVE #240
PITTSBURGH PA
15224-1770
US

IV. Provider business mailing address

262 FIELD CLUB CIR
MC KEES ROCKS PA
15136-1033
US

V. Phone/Fax

Practice location:
  • Phone: 412-235-5870
  • Fax:
Mailing address:
  • Phone: 412-788-4022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number63439
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR203872
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN282715L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: