MEDICARE: AARON SMUCKLER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD430979	PA

General Provider Information

NPI Number	:	1144232406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AARON SMUCKLER

Provider Business Mailing Address
First Line	:	619 MOUNT ROYAL BLVD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15223-1225
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	619 MOUNT ROYAL BLVD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15223-1225
Country	:	US
Telephone Number	:	412-487-4422
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2006
Last Update Date	:	03/25/2021

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