Provider Demographics
NPI:1306935036
Name:GOSALIA, ANKUR (MD)
Entity type:Individual
Prefix:
First Name:ANKUR
Middle Name:
Last Name:GOSALIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1424 MYSTIC VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-8873
Mailing Address - Country:US
Mailing Address - Phone:412-680-0526
Mailing Address - Fax:
Practice Address - Street 1:119 VIP DR
Practice Address - Street 2:SUITE G-015
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-7976
Practice Address - Country:US
Practice Address - Phone:412-533-2202
Practice Address - Fax:412-774-2929
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD428877207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1018566980001Medicaid
OH2767411Medicaid
WV3810008990Medicaid
OH2767411Medicaid