Provider Demographics
NPI:1316987662
Name:EGIDI, KELLIE MICHELE (PA)
Entity type:Individual
Prefix:PROF
First Name:KELLIE
Middle Name:MICHELE
Last Name:EGIDI
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:1000 BOWER HILL RD
Mailing Address - Street 2:ATTN ST CLAIR HOSPITAL - AFFILIATE BILLING - PAMALYN
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1873
Mailing Address - Country:US
Mailing Address - Phone:412-942-2674
Mailing Address - Fax:412-942-2689
Practice Address - Street 1:717 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15228-2001
Practice Address - Country:US
Practice Address - Phone:412-341-7887
Practice Address - Fax:412-341-1479
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2021-03-09
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Provider Licenses
StateLicense IDTaxonomies
PAMA002530L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine