Basic Information
| Provider Information | |||||||||
| NPI: | 1154457570 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UPMC COMMUNITY MEDICINE INC | ||||||||
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| OtherOrganizationName: | BEDFORD COUNTY PEDIATRIC ASSOC UPMC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 LOTHROP ST | ||||||||
| Address2: | SUITE 9055 FORBES TOWER | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152132536 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126470943 | ||||||||
| FaxNumber: | 4126474050 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 LOTHROP ST | ||||||||
| Address2: | SUITE 9055 FORBES TOWER | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152132536 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126470943 | ||||||||
| FaxNumber: | 4126474050 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/27/2007 | ||||||||
| LastUpdateDate: | 11/09/2007 | ||||||||
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| AuthorizedOfficialLastName: | EHALT | ||||||||
| AuthorizedOfficialFirstName: | MARK | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 4126470943 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.