Provider Demographics
NPI:1427089796
Name:MEADE, MARY ANNE (PAC)
Entity type:Individual
Prefix:MRS
First Name:MARY ANNE
Middle Name:
Last Name:MEADE
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 BOWERHILL RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15215
Mailing Address - Country:US
Mailing Address - Phone:412-572-6197
Mailing Address - Fax:412-572-6195
Practice Address - Street 1:1050 BOWERHILL RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15215
Practice Address - Country:US
Practice Address - Phone:412-572-6197
Practice Address - Fax:412-572-6195
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA001217L363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA113133KJSMedicare PIN
PAS88532Medicare UPIN