Provider Demographics
NPI:1902899495
Name:MEIHOFER, MARY (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:MEIHOFER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 536003
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15253-5902
Mailing Address - Country:US
Mailing Address - Phone:800-475-6236
Mailing Address - Fax:843-497-9566
Practice Address - Street 1:100 S 2ND ST
Practice Address - Street 2:STE 301
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17101-2545
Practice Address - Country:US
Practice Address - Phone:717-782-3340
Practice Address - Fax:717-782-5352
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD046729L207ZB0001X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015189100005Medicaid
PA0015189100008Medicaid
PAP00038128OtherRAILROAD MEDICARE
PAF91318Medicare UPIN
PA531786G03Medicare PIN