Basic Information
Provider Information
NPI: 1003000407
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GIRARDI
FirstName: DAVID
MiddleName: JAMES
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 306 PENN AVE
Address2:  
City: PITTSBURGH
State: PA
PostalCode: 152212134
CountryCode: US
TelephoneNumber: 4122415341
FaxNumber: 4122415394
Practice Location
Address1: 306 PENN AVE
Address2:  
City: PITTSBURGH
State: PA
PostalCode: 152212134
CountryCode: US
TelephoneNumber: 4122415341
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/29/2007
LastUpdateDate: 05/14/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/14/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XOS012940PAY Allopathic & Osteopathic PhysiciansFamily Medicine 
208M00000XOS012940PAN Allopathic & Osteopathic PhysiciansHospitalist 

ID Information
IDTypeStateIssuerDescription
10202111005PA MEDICAID


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