Provider Demographics
NPI:1366407264
Name:KNEZ, DAVID J
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:KNEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 EMERSON LN STE 1503
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-3484
Mailing Address - Country:US
Mailing Address - Phone:412-977-2051
Mailing Address - Fax:
Practice Address - Street 1:100 EMERSON LN STE 1503
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-3484
Practice Address - Country:US
Practice Address - Phone:412-977-2051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS009476L207L00000X, 2083A0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0061251000Medicaid
PA0016625100004Medicaid
OH0175457Medicaid
PA000287NHDMedicare PIN
PA0016625100004Medicaid
PA000287Medicare PIN