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General NPI Number Information
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NPI Number | 1124047816
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Entity Type | Individual
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Provider Name | GERALD DAVID KLUG MD
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Gender | Male
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 12/21/2018
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Provider Practice Location Address
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Address Line | 3528 BLVD OF THE ALLIES
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City | PITTSBURGH
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State | PA
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Zip | 15213-4355
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Country | US
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Telephone | 412-681-1406
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Fax | 412-681-1408
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Provider Business Mailing Address
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Address Line | 109 PINE ACRES LN
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City | CORAOPOLIS
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State | PA
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Zip | 15108-2968
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Country | US
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Telephone | 412-225-9054
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD032913-E
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License Number State | PA
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