Provider Demographics
NPI:1154319721
Name:DELONG, STEPHEN R (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:R
Last Name:DELONG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:400 PENN CENTER BLVD
Mailing Address - Street 2:STE 555
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-5613
Mailing Address - Country:US
Mailing Address - Phone:412-829-7288
Mailing Address - Fax:412-829-1310
Practice Address - Street 1:2570 HAYMAKER RD
Practice Address - Street 2:DEPARTMENT OF RADIOLOGY
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3513
Practice Address - Country:US
Practice Address - Phone:412-858-2343
Practice Address - Fax:412-373-0861
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2008-07-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD021983E2085N0904X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADE139699OtherHIGHMARK
PA00166977000OtherINDEPENDENCE BLUE CROSS
PA0009515820013Medicaid
PA00166977000OtherINDEPENDENCE BLUE CROSS
B38949Medicare UPIN
139699Medicare ID - Type Unspecified