MEDICARE: GATEWAY MEDICAL GROUP, INC

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	207R00000X	Internal Medicine Physician

Other Identifiers

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

General Provider Information

NPI Number	:	1811936255
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GATEWAY MEDICAL GROUP, INC

Provider Business Mailing Address
First Line	:	1100 WASHINGTON AVE
Second Line	:	STE 115
City	:	CARNEGIE
State	:	PA
Zip	:	15106-3614
Country	:	US
Telephone Number	:	412-279-8940
Fax Number	:	412-279-8871

Provider Business Practice Location Address
First Line	:	1100 WASHINGTON AVE
Second Line	:	STE 115
City	:	CARNEGIE
State	:	PA
Zip	:	15106-3614
Country	:	US
Telephone Number	:	412-279-8940
Fax Number	:	412-279-8871

Authorized Official
Title or Position	:	MANAGER
Name	:	ROSE SACCO
Credential	:
Telephone Number	:	412-279-8940

Provider Enumeration Date	:	06/04/2006
Last Update Date	:	07/21/2022

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Directions to “GATEWAY MEDICAL GROUP, INC ” Practice Location

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