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General NPI Number Information
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NPI Number | 1407105695
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Entity Type | Individual
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Provider Name | WILLIAM DANIEL TRUSNOVIC JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/04/2012
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Last Update Date | 04/26/2024
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Provider Practice Location Address
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Address Line | 90 W CHESTNUT ST SUITE 400
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City | WASHINGTON
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State | PA
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Zip | 15301-4524
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Country | US
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Telephone | 724-206-9535
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Fax | 724-503-4185
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Provider Business Mailing Address
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Address Line | 90 W CHESTNUT ST SUITE 400
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City | WASHINGTON
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State | PA
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Zip | 15301-4524
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Country | US
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Telephone | 724-206-9535
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Fax | 724-503-4185
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 16697
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | MD-059947-L
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License Number State | PA
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