Provider Demographics
NPI:1538175070
Name:INTERNAL MEDICINE AND GERIATRICS OF WASHINGTON
Entity type:Organization
Organization Name:INTERNAL MEDICINE AND GERIATRICS OF WASHINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HAHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-222-4464
Mailing Address - Street 1:880 SOUTH MAIN STREET
Mailing Address - Street 2:SOUTH MINSTER PLACE
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301
Mailing Address - Country:US
Mailing Address - Phone:724-222-4464
Mailing Address - Fax:724-222-5706
Practice Address - Street 1:880 SOUTH MAIN STREET
Practice Address - Street 2:SOUTH MINSTER PLACE
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301
Practice Address - Country:US
Practice Address - Phone:724-222-4464
Practice Address - Fax:724-222-5706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1538175070Medicare PIN