MEDICARE: CAITLIN KOERBER

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	208000000X	Pediatrics Physician	MD454808	PA

General Provider Information

NPI Number	:	1578839718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAITLIN KOERBER

Provider Business Mailing Address
First Line	:	11279 PERRY HWY
Second Line	:	SUITE 450
City	:	WEXFORD
State	:	PA
Zip	:	15090-9381
Country	:	US
Telephone Number	:	724-933-1100
Fax Number	:	724-933-1160

Provider Business Practice Location Address
First Line	:	1220 LINCOLN WAY
Second Line	:
City	:	WHITE OAK
State	:	PA
Zip	:	15131-1642
Country	:	US
Telephone Number	:	412-673-2200
Fax Number	:	412-673-3205

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

Provider Enumeration Date	:	03/30/2012
Last Update Date	:	04/19/2017

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Directions to “ CAITLIN KOERBER ” Practice Location

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