Provider Demographics
NPI:1831254705
Name:REILLY, JAMES B (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:B
Last Name:REILLY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:320 E NORTH AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4756
Mailing Address - Country:US
Mailing Address - Phone:412-359-3319
Mailing Address - Fax:412-359-4136
Practice Address - Street 1:320 E NORTH AVE FL 4
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4756
Practice Address - Country:US
Practice Address - Phone:412-359-3319
Practice Address - Fax:412-359-4136
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD437509207RN0300X, 207RN0300X
PAMT185879207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102453714Medicaid
PA102453714Medicaid