MEDICARE: DR. DAVID JOHN MONROE O.D.

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	152W00000X	Optometrist	OEG000797	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	160594	OTHER	PA	COLE MANAGED VISION
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	121934	OTHER	PA	HEALTHASSURANCE/HEALTHAME
4	78019	OTHER	PA	AETNA/USHEALTHCARE
5	565232	OTHER	PA	BLUE CROSS/BLUE SHIELD
6	308997	OTHER	PA	UPMC

General Provider Information

NPI Number	:	1194710749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID JOHN MONROE O.D.

Provider Business Mailing Address
First Line	:	202 OVERBROOK TER
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15239-1079
Country	:	US
Telephone Number	:	412-793-2114
Fax Number	:

Provider Business Practice Location Address
First Line	:	214 CORBET ST
Second Line	:
City	:	TARENTUM
State	:	PA
Zip	:	15084-1815
Country	:	US
Telephone Number	:	724-224-8806
Fax Number	:	724-224-0828

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

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	07/01/2008

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