Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 028419 | PA |
Y | 213EG0000X | General Practice | 028419 | PA |
NPI | 1003905373 |
---|---|
Provider Name | Dr. George G. Bellios |
First Address | Pittsburgh, PA 15232-1738 |
Second Address | Pittsburgh, PA 15216-2319 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01512000 | TAX ID NUMBER (01) | PA |
015192 | UNITED CONCORDIA PROVIDER (01) | PA |