Provider Demographics
NPI:1215151667
Name:DIAGNOSTIC DIGESTIVE DISEASES ASSOCIATES P C
Entity type:Organization
Organization Name:DIAGNOSTIC DIGESTIVE DISEASES ASSOCIATES P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KOTAYYA
Authorized Official - Middle Name:E
Authorized Official - Last Name:KONDAVEETI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-621-0220
Mailing Address - Street 1:4815 LIBERTY AVE
Mailing Address - Street 2:SUITE 453
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2156
Mailing Address - Country:US
Mailing Address - Phone:412-621-0220
Mailing Address - Fax:412-621-5486
Practice Address - Street 1:4815 LIBERTY AVE
Practice Address - Street 2:SUITE 453
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2156
Practice Address - Country:US
Practice Address - Phone:412-621-0220
Practice Address - Fax:412-621-5486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty