MEDICARE: DR. LISA ANN GOSS 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	207Q00000X	Family Medicine Physician	MD071791L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00911363	OTHER	PA	HIGHMARK
2	306179	OTHER		UNISON
3	213137	OTHER		UPMC
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740202217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA ANN GOSS M.D.

Provider Business Mailing Address
First Line	:	95 LEONARD AVE
Second Line	:	BLDG 2
City	:	WASHINGTON
State	:	PA
Zip	:	15301-3368
Country	:	US
Telephone Number	:	724-223-3100
Fax Number	:	724-223-3353

Provider Business Practice Location Address
First Line	:	67 E PIKE ST
Second Line	:
City	:	CANONSBURG
State	:	PA
Zip	:	15317-1311
Country	:	US
Telephone Number	:	724-745-4100
Fax Number	:	724-746-9880

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

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	10/13/2010

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