Provider Demographics
NPI:1205165370
Name:MCCANDLESS, AUDREY R (MD)
Entity type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:R
Last Name:MCCANDLESS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AUDREY
Other - Middle Name:R
Other - Last Name:ROSENGARTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:230 MCKEE PL
Mailing Address - Street 2:SUITE 500
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3903
Mailing Address - Country:US
Mailing Address - Phone:412-647-8283
Mailing Address - Fax:
Practice Address - Street 1:230 MCKEE PL
Practice Address - Street 2:SUITE 500
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3903
Practice Address - Country:US
Practice Address - Phone:412-647-8283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-18
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT192775207P00000X
PAMD440700207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine