Provider Demographics
NPI:1538160718
Name:BOYKIW, MARK E (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:E
Last Name:BOYKIW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:841 HOSPITAL RD
Mailing Address - Street 2:SUITE 3100
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3620
Mailing Address - Country:US
Mailing Address - Phone:724-349-3170
Mailing Address - Fax:724-349-3410
Practice Address - Street 1:841 HOSPITAL RD
Practice Address - Street 2:SUITE 3100
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3620
Practice Address - Country:US
Practice Address - Phone:724-349-3170
Practice Address - Fax:724-349-3410
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD021715E208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1277920OtherUMWA FUNDS
PA5479306OtherAETNA
PA252167OtherUPMC
PA1503139OtherGATEWAY HEALTH PLAN
PA020046431OtherRAILROAD MEDICARE
PA0008638910003Medicaid
PA1277920OtherUMWA FUNDS
PA252167OtherUPMC