Individual
WALLACE C GAUNTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
824 CALIFORNIA AVE, PITTSBURGH, PA 15202-2706
(412) 766-3232
(412) 766-4320
Mailing address
824 CALIFORNIA AVE, PITTSBURGH, PA 15202-2706
(412) 766-3232
(412) 766-4320
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
35068280
OH
207RN0300X
Nephrology Physician
Primary
MD019281E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000793311
—
PA
05
—
0070822000
—
WV
05
—
0642228
—
OH
01
—
110025252
RAILROAD MEDICARE
—
Enumeration date
06/01/2005
Last updated
01/15/2020
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