Provider Demographics
NPI:1841379286
Name:SHIPKOVITZ, HARVEY D (MD)
Entity type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:D
Last Name:SHIPKOVITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:590 OLD MILL RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-1918
Mailing Address - Country:US
Mailing Address - Phone:412-963-1370
Mailing Address - Fax:412-963-6245
Practice Address - Street 1:1312 FEDERAL ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4706
Practice Address - Country:US
Practice Address - Phone:412-321-0255
Practice Address - Fax:412-321-3452
Is Sole Proprietor?:No
Enumeration Date:2006-11-05
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD015126E207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00061276OtherUNISON ADVANTAGE
PA0006585040001Medicaid
103793OtherBLUE CROSS/BLUE SHIELD
103793OtherBLUE CROSS/BLUE SHIELD
103793KD3Medicare PIN