Provider Demographics
NPI:1588715643
Name:GEORGEVICH & ASSOCIATES LLC
Entity type:Organization
Organization Name:GEORGEVICH & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:G
Authorized Official - Last Name:GEORGEVICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:4120-771-2121
Mailing Address - Street 1:1800 PINE HOLLOW RD
Mailing Address - Street 2:SUTIE2B
Mailing Address - City:MC KEES ROCKS
Mailing Address - State:PA
Mailing Address - Zip Code:15136-1516
Mailing Address - Country:US
Mailing Address - Phone:412-771-2121
Mailing Address - Fax:412-771-1855
Practice Address - Street 1:1800 PINE HOLLOW RD
Practice Address - Street 2:SUTIE2B
Practice Address - City:MC KEES ROCKS
Practice Address - State:PA
Practice Address - Zip Code:15136-1516
Practice Address - Country:US
Practice Address - Phone:412-771-2121
Practice Address - Fax:412-771-1855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD027326E2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty