Provider Demographics
NPI:1871559401
Name:CHARLEY, JOHN ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ANDREW
Last Name:CHARLEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1340 OLD FREEPORT ROAD
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-4101
Mailing Address - Country:US
Mailing Address - Phone:412-967-9505
Mailing Address - Fax:412-967-9507
Practice Address - Street 1:1340 OLD FREEPORT ROAD
Practice Address - Street 2:SUITE 1A
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-4101
Practice Address - Country:US
Practice Address - Phone:412-967-9505
Practice Address - Fax:412-967-9507
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-22
Last Update Date:2010-07-02
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Provider Licenses
StateLicense IDTaxonomies
PAMD031662E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C33186Medicare UPIN
PA192802Medicare PIN