Provider Demographics
NPI:1699766931
Name:JOSEPH, GEORGE (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:JOSEPH
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:PO BOX 645532
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15264-5253
Mailing Address - Country:US
Mailing Address - Phone:740-792-4220
Mailing Address - Fax:740-314-5185
Practice Address - Street 1:243 THREE SPRINGS DR STE 5A
Practice Address - Street 2:
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-3839
Practice Address - Country:US
Practice Address - Phone:740-792-4220
Practice Address - Fax:740-275-4472
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.081603207RC0001X
WV24319207RC0001X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVWV8033G394OtherPTAN
OH3126441Medicaid
OH3126441Medicaid
OKP00262325OtherRAILROAD MEDICARE
OKP00262325OtherRAILROAD MEDICARE
WV4310801Medicare PIN
OK24H616529Medicare PIN
OKOKA100869Medicare PIN
G39515Medicare UPIN