Basic Information
| Provider Information | |||||||||
| NPI: | 1598195331 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CONTEMPORARY MEDICAL AND PHYSICAL MEDICINE LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2850 SAW MILL RUN BLVD | ||||||||
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| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152271714 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4128823300 | ||||||||
| FaxNumber: | 4128822661 | ||||||||
| Practice Location | |||||||||
| Address1: | 2275 SWALLOW HILL RD | ||||||||
| Address2: | BLDG. 2600 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152201656 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4122794522 | ||||||||
| FaxNumber: | 4122793416 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/14/2013 | ||||||||
| LastUpdateDate: | 11/14/2013 | ||||||||
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| AuthorizedOfficialLastName: | LEONARD | ||||||||
| AuthorizedOfficialFirstName: | DEBRA | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | CREDENTIALING MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 4122794522 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | MD420553 | PA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.