MEDICARE: BANKSVILLE MEDICAL, PC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1979748	OTHER	PA	HIGHMARK BC/BS

General Provider Information

NPI Number	:	1144412594
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BANKSVILLE MEDICAL, PC

Provider Business Mailing Address
First Line	:	2508 BANKSVILLE AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15216-2802
Country	:	US
Telephone Number	:	412-341-6650
Fax Number	:

Provider Business Practice Location Address
First Line	:	2508 BANKSVILLE AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15216-2802
Country	:	US
Telephone Number	:	412-341-6650
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CHARLES F DIEDERICH I
Credential	:	M.D.
Telephone Number	:	412-341-6650

Provider Enumeration Date	:	08/09/2007
Last Update Date	:	10/11/2007

Similar Medicare Providers

1780516369 — OPENMIND BEHAVIORAL HEALTH
Practice Location Address:

634 ALPHA DR
PITTSBURGH, PA
15238-2802

Practice Phone: 412-874-8401
Practice Fax:

1861440992 — DAVID HUMPHREYS CRNP-MSN
Practice Location Address:

634 ALPHA DR , SUITE 600
PITTSBURGH, PA
15238-2802

Practice Phone: 610-892-8991
Practice Fax:

1497775647 — KIM BANKS CRNP
Practice Location Address:

634 ALPHA DR , SUITE 600
PITTSBURGH, PA
15238-2802

Practice Phone: 610-892-8991
Practice Fax:

1760616759 — SUSAN E GUSTAFSON CRNP
Practice Location Address:

634 ALPHA DR , SUITE 600
PITTSBURGH, PA
15238-2802

Practice Phone: 610-892-8991
Practice Fax: 610-892-8991

1386194579 — MRS. SUSAN ELIZABETH RANIER BEIL MA CCC/SLP
Practice Location Address:

1586 ASHLAWN DR
PITTSBURGH, PA
15241-2802

Practice Phone: 412-287-7926
Practice Fax:

1720580871 — MRS. CAMDEN BIANCO LPC
Practice Location Address:

4729 ELLSWORTH AVE
PITTSBURGH, PA
15213-2802

Practice Phone: 412-621-4361
Practice Fax:

Directions to “BANKSVILLE MEDICAL, PC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.