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General NPI Number Information
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NPI Number | 1013940063
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Entity Type | Organization
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Legal Business Name | MEDICAL & SURGICAL EYE ASSOCIATES INC
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 05/08/2013
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Provider Practice Location Address
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Address Line | 2400 ARDMORE BLVD SUITE 201
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City | PITTSBURGH
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State | PA
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Zip | 15221-5299
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Country | US
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Telephone | 412-351-2017
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Fax |
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Provider Business Mailing Address
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Address Line | 2400 ARDMORE BLVD SUITE 201
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City | PITTSBURGH
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State | PA
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Zip | 15221-5299
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Country | US
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Telephone | 412-351-2017
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOHN M MIKULLA
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Credential | MD
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Telephone | 412-351-3062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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