Provider Demographics
NPI:1194724278
Name:KING, EDWIN B (MD)
Entity type:Individual
Prefix:
First Name:EDWIN
Middle Name:B
Last Name:KING
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1580 MCLAUGHLIN RUN RD
Mailing Address - Street 2:PINE BRIDGE COMMONS, SUITE 208
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-3100
Mailing Address - Country:US
Mailing Address - Phone:412-221-2121
Mailing Address - Fax:412-221-7224
Practice Address - Street 1:1580 MCLAUGHLIN RUN RD
Practice Address - Street 2:PINE BRIDGE COMMONS, SUITE 208
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-3100
Practice Address - Country:US
Practice Address - Phone:412-221-2121
Practice Address - Fax:412-221-7224
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2020-10-02
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Provider Licenses
StateLicense IDTaxonomies
PAMD072470L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018403270002Medicaid
PA0018403270002Medicaid