MEDICARE: DONALD KUSHNER M.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	174400000X	Specialist	MD-046207L	PA
2	207R00000X	Internal Medicine Physician	MD046207L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110136230	OTHER		RAILROAD MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295792455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD KUSHNER M.D.

Provider Business Mailing Address
First Line	:	1401 CANDLEWOOD DR
Second Line	:
City	:	UPPER ST CLAIR
State	:	PA
Zip	:	15241-2907
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1050 BOWER HILL RD
Second Line	:	SUITE 202
City	:	PITTSBURGH
State	:	PA
Zip	:	15243-1800
Country	:	US
Telephone Number	:	412-572-6122
Fax Number	:	412-561-0318

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

Provider Enumeration Date	:	04/28/2006
Last Update Date	:	04/19/2011

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Directions to “ DONALD KUSHNER M.D.” Practice Location

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