Provider Demographics
NPI:1205079837
Name:PURNELL, GREGORY JOSEPH JR (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:JOSEPH
Last Name:PURNELL
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:2550 MOSSIDE BLVD
Mailing Address - Street 2:SUITE 405
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3540
Mailing Address - Country:US
Mailing Address - Phone:412-373-1600
Mailing Address - Fax:412-373-4197
Practice Address - Street 1:2550 MOSSIDE BLVD
Practice Address - Street 2:SUITE 405
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3540
Practice Address - Country:US
Practice Address - Phone:412-373-1600
Practice Address - Fax:412-373-4197
Is Sole Proprietor?:No
Enumeration Date:2009-04-13
Last Update Date:2020-10-12
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Provider Licenses
StateLicense IDTaxonomies
PAMD 436136207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102955331Medicaid
PA12726996OtherCAQH
PA003070990OtherHIGHMARK
PA12726996OtherCAQH