Basic Information
| Provider Information | |||||||||
| NPI: | 1013302207 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | UNIVERSITY OF PITTSBURGH PHYSICIANS | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | MUSKULOSKELETAL HOME | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3471 5TH AVE | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152133215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126470100 | ||||||||
| FaxNumber: | 4126474050 | ||||||||
| Practice Location | |||||||||
| Address1: | 3471 5TH AVE | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152133215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126470100 | ||||||||
| FaxNumber: | 4126474050 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2015 | ||||||||
| LastUpdateDate: | 04/03/2015 | ||||||||
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| AuthorizedOfficialLastName: | EHALT | ||||||||
| AuthorizedOfficialFirstName: | MARK | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 4124325304 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | UNIVERSITY OF PITTSBURGH PHYSICIANS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207RR0500X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 208100000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 207X00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.