Organization
CHARLES L. PUCEVICH, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUIE HALL (OFFICE MANAGER)
(412) 262-1064
Entity
Organization
Contact information
Practice address
935 THORN RUN RD, CORAOPOLIS, PA 15108-2861
(412) 262-1064
(412) 262-3904
Mailing address
935 THORN RUN RD, CORAOPOLIS, PA 15108-2861
(412) 262-1064
(412) 262-3904
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
MD027250E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008635880001
—
PA
Enumeration date
01/05/2007
Last updated
07/07/2008
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