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General NPI Number Information
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NPI Number | 1689664070
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Entity Type | Individual
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Provider Name | MARK S STANISH M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/26/2005
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | PITTSBURGH CATHOLIC CHARITIES FREE HEALTH CARE 111 BOULEVARD OF THE ALLIES
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City | PITTSBURGH
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State | PA
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Zip | 15222
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Country | US
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Telephone | 412-456-6999
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Fax | 574-239-1520
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Provider Business Mailing Address
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Address Line | 101 SCOTTDALE DR
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City | PITTSBURGH
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State | PA
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Zip | 15205
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Country | US
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Telephone | 574-292-1329
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Fax | 574-239-1520
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01039400A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301046691
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD478613
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License Number State | PA
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