Provider Demographics
NPI:1770588063
Name:PISTON, ROBERT WALTER (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:WALTER
Last Name:PISTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3120 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-4512
Mailing Address - Country:US
Mailing Address - Phone:724-342-2663
Mailing Address - Fax:724-342-8988
Practice Address - Street 1:3120 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-4512
Practice Address - Country:US
Practice Address - Phone:724-342-2663
Practice Address - Fax:724-342-8988
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038306E207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
609653500OtherUS DEPT. OF LABOR
PA200036507OtherRAILROAD MEDICARE
PA0012802950002Medicaid
201103OtherUPMC
PA000680063OtherHIGHMARK BC/BS
316340OtherHEALTH AMERICA
OH0893681Medicaid
PA25-1725497OtherFEDERAL TAX IDENTIFICATION NUMBER
PA25-1725497OtherFEDERAL TAX IDENTIFICATION NUMBER
PA000680063OtherHIGHMARK BC/BS
PA0012802950002Medicaid
PA680063K4RMedicare PIN