Provider Demographics
NPI:1053470526
Name:HAIDER, BUSHRA (MD)
Entity type:Individual
Prefix:
First Name:BUSHRA
Middle Name:
Last Name:HAIDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 LOTHROP ST
Mailing Address - Street 2:SUITE 9055 FORBES TOWER
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2536
Mailing Address - Country:US
Mailing Address - Phone:412-647-3087
Mailing Address - Fax:412-647-4486
Practice Address - Street 1:6502 STEUBENVILLE PIKE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-1006
Practice Address - Country:US
Practice Address - Phone:412-788-1002
Practice Address - Fax:412-787-3475
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD423231207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000169074OtherUNISON HEALTH PLAN
PA001653345OtherHIGHMARK BLUE SHIELD
1544126OtherGATEWAY HEALTH PLAN
PA1013394100001Medicaid
000000169074OtherUNISON HEALTH PLAN