Basic Information
Provider Information
NPI: 1982182754
EntityType: 2
ReplacementNPI:  
OrganizationName: PINNACLE HEALTH MEDICAL SERVICES
LastName:  
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Credential:  
OtherOrganizationName: UPMC PINNACLE MOUNTAIN VIEW OBSTETRICS AND GYNECOLOGY
OtherOrganizationType: 3
OtherLastName:  
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Mailing Information
Address1: 409 S 2ND ST STE 2F
Address2:  
City: HARRISBURG
State: PA
PostalCode: 171041612
CountryCode: US
TelephoneNumber: 7172318929
FaxNumber: 7172215673
Practice Location
Address1: 20 NORTH ST
Address2:  
City: HANOVER
State: PA
PostalCode: 173312275
CountryCode: US
TelephoneNumber: 7176377755
FaxNumber: 7176377142
Other Information
ProviderEnumerationDate: 08/02/2018
LastUpdateDate: 11/09/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: MARKLEY
AuthorizedOfficialFirstName: CHRISTOPHER
AuthorizedOfficialMiddleName: P
AuthorizedOfficialTitleorPosition: SENIOR VP
AuthorizedOfficialTelephone: 7172318210
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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NPICertificationDate: 11/09/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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