Provider Demographics
NPI:1992724827
Name:MCGOWAN, IAN MICHAEL (MD PHD)
Entity type:Individual
Prefix:DR
First Name:IAN
Middle Name:MICHAEL
Last Name:MCGOWAN
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 MARYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-2503
Mailing Address - Country:US
Mailing Address - Phone:412-641-4710
Mailing Address - Fax:412-641-4710
Practice Address - Street 1:204 CRAFT AVE
Practice Address - Street 2:ROOM B505
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3005
Practice Address - Country:US
Practice Address - Phone:412-641-4710
Practice Address - Fax:412-641-6170
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF5032207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00F50320OtherMEDICAL PPIN #
CAH72548Medicare UPIN
CAWF5032BMedicare ID - Type UnspecifiedPPIN #
CAWF5032AMedicare ID - Type UnspecifiedPPIN #