MEDICARE: MARK S GEORGIADIS 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	207RH0003X	Hematology & Oncology Physician	MD061189L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10765060	OTHER	PA	CAQH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	902487	OTHER	PA	HIGHMARK BS

General Provider Information

NPI Number	:	1437120441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK S GEORGIADIS M.D.

Provider Business Mailing Address
First Line	:	2 HOT METAL ST
Second Line	:	QUANTUM ONE, N430
City	:	PITTSBURGH
State	:	PA
Zip	:	15203-2348
Country	:	US
Telephone Number	:	412-432-7706
Fax Number	:	412-432-7691

Provider Business Practice Location Address
First Line	:	200 DELAFIELD RD
Second Line	:	SUITE 3050
City	:	PITTSBURGH
State	:	PA
Zip	:	15215-3205
Country	:	US
Telephone Number	:	412-781-3744
Fax Number	:	412-781-3793

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

Provider Enumeration Date	:	01/28/2006
Last Update Date	:	12/06/2013

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