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Organization
RUDOLPH ANTONCIC III, M.D., P.C.
Active
Organization
RUDOLPH ANTONCIC III, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUDOLPH ANDREW ANTONCIC III M.D. (OWNER)
(412) 754-3770
Entity
Organization
Contact information
Practice address
5301 WALNUT ST, MCKEESPORT, PA 15132-6327
(412) 751-4400
(412) 751-4881
Mailing address
2255 GREENOCK BUENA VISTA RD, MCKEESPORT, PA 15135-3007
(412) 754-3770
(412) 896-0627
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD418006
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019003720001
—
PA
01
—
125036
UNISON HEALTH PLAN
—
01
—
1385401
HIGHMARK BLUE SHIELD
PA
01
—
1521997
GATEWAY HEALTH PLAN
—
01
—
2074615000
INDEPENDENCE BLUE
—
01
—
262531
HEALTH AMERICA
—
01
—
308210
UPMC HEALTH PLAN
—
01
—
75640
AETNA
—
Enumeration date
07/05/2007
Last updated
10/25/2007
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