Individual
PHILLIP C DIAS-MANDOLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 HAZEL LANE, SUITE 300, SEWICKLEY, PA 15143-1253
(412) 749-7330
(412) 749-6763
Mailing address
111 HAZEL LANE, SUITE 300, SEWICKLEY, PA 15143-1253
(412) 749-7330
(412) 749-6763
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD040982E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016538160002
—
PA
05
—
01653816
—
PA
Enumeration date
08/18/2006
Last updated
11/29/2010
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