Healthcare Provider Details

I. General information

NPI: 1699745919
Provider Name (Legal Business Name): MARTIN EARLE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 10/28/2021
Certification Date: 10/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1907 LEBANON CHURCH RD
WEST MIFFLIN PA
15122-2432
US

IV. Provider business mailing address

1907 LEBANON CHURCH RD
WEST MIFFLIN PA
15122-2432
US

V. Phone/Fax

Practice location:
  • Phone: 412-653-8100
  • Fax: 412-563-8120
Mailing address:
  • Phone: 412-563-8100
  • Fax: 412-653-8120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD027013E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: