Provider Demographics
NPI:1396759460
Name:KISER, ANDY CHRISTOPHER (MD)
Entity type:Individual
Prefix:
First Name:ANDY
Middle Name:CHRISTOPHER
Last Name:KISER
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 1:1000 BOWER HILL ROAD
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:412-942-2548
Mailing Address - Fax:
Practice Address - Street 1:1050 BOWER HILL RD STE 204
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1868
Practice Address - Country:US
Practice Address - Phone:412-942-5278
Practice Address - Fax:412-942-5738
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC93-00501208G00000X
NC9300501208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8912519Medicaid
NC12519OtherBCBS OF NC
SCN00503Medicaid
NC12519OtherBCBS
NC1396759460Medicaid
NCFH2000605OtherFIRSTCAROLINA CARE
NCFH2000605OtherFIRSTCAROLINA CARE
NCP00478619 RAILROADMedicare PIN
NCH12935Medicare UPIN
NC8912519Medicaid