Provider Demographics
NPI:1871787952
Name:G. ALAN YEASTED, MD
Entity type:Organization
Organization Name:G. ALAN YEASTED, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:G. ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YEASTED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-572-6066
Mailing Address - Street 1:3515 WASHINGTON RD
Mailing Address - Street 2:SUITE 570
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-3063
Mailing Address - Country:US
Mailing Address - Phone:412-572-6066
Mailing Address - Fax:412-561-0785
Practice Address - Street 1:3515 WASHINGTON RD
Practice Address - Street 2:SUITE 570
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-3063
Practice Address - Country:US
Practice Address - Phone:412-572-6066
Practice Address - Fax:412-561-0785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1544856OtherGATEWAY MEDICARE ASSURED
102028OtherUPMC HEALTH PLAN
148680OtherHEALTH AMERICA
PA069068Medicare PIN