MEDICARE: DR. MICHAEL ANGELO PEZZONE MD

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	207RG0100X	Gastroenterology Physician	ME128692	FL
2	174400000X	Specialist	MD060508L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME128692	OTHER	FL	STATE LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164497699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL ANGELO PEZZONE MD

Provider Business Mailing Address
First Line	:	1515 LOCUST ST STE 500
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15219-5131
Country	:	US
Telephone Number	:	412-232-8888
Fax Number	:	412-232-8887

Provider Business Practice Location Address
First Line	:	1515 LOCUST ST STE 500
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15219-5131
Country	:	US
Telephone Number	:	412-232-8888
Fax Number	:	412-232-8887

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

Provider Enumeration Date	:	02/20/2006
Last Update Date	:	10/05/2019

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Directions to “ DR. MICHAEL ANGELO PEZZONE MD” Practice Location

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