Provider Demographics
NPI:1972959153
Name:D & P MEDICAL GROUP LLC
Entity type:Organization
Organization Name:D & P MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DONER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:412-496-6365
Mailing Address - Street 1:PO BOX 791
Mailing Address - Street 2:
Mailing Address - City:CARNEGIE
Mailing Address - State:PA
Mailing Address - Zip Code:15106-0791
Mailing Address - Country:US
Mailing Address - Phone:412-655-4362
Mailing Address - Fax:
Practice Address - Street 1:316 1ST AVE STE 200
Practice Address - Street 2:
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-2267
Practice Address - Country:US
Practice Address - Phone:412-655-4362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-06
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS015400207PE0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1031380280007Medicaid
PAOS015499OtherSTATE LICENSE