Basic Information
| Provider Information | |||||||||
| NPI: | 1164431631 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | UNIVERSITY OF PITTSBURGH PHYSICIANS | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | UPP ORTHOPAEDICS-DME | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 LOTHROP ST | ||||||||
| Address2: | SUITE 9055 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152132536 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126470943 | ||||||||
| FaxNumber: | 4126474050 | ||||||||
| Practice Location | |||||||||
| Address1: | 3471 5TH AVE | ||||||||
| Address2: | SUITE 1010 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152133215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126470943 | ||||||||
| FaxNumber: | 4126474050 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2006 | ||||||||
| LastUpdateDate: | 10/30/2007 | ||||||||
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| AuthorizedOfficialLastName: | EHALT | ||||||||
| AuthorizedOfficialFirstName: | MARK | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR, REVENUE CYCLE | ||||||||
| AuthorizedOfficialTelephone: | 4126470943 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 335E00000X | Y | Suppliers | Prosthetic/Orthotic Supplier |
No ID Information.