Provider Demographics
NPI:1699956599
Name:YESTER, MARC ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:ALAN
Last Name:YESTER
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 1:240 MOUNT LEBANON BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15234-1243
Mailing Address - Country:US
Mailing Address - Phone:412-561-7541
Mailing Address - Fax:
Practice Address - Street 1:3055 WASHINGTON RD
Practice Address - Street 2:SUITE 102
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-3279
Practice Address - Country:US
Practice Address - Phone:724-969-5025
Practice Address - Fax:724-969-5001
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-19
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA439235208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102504386-0003Medicaid