Provider Demographics
NPI:1003895210
Name:ALLEGHENY MEDICAL PRACTICE NETWORK
Entity Type:Organization
Organization Name:ALLEGHENY MEDICAL PRACTICE NETWORK
Other - Org Name:WILLIAM P. COYLE, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGED CARE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTEMIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-330-5523
Mailing Address - Street 1:400 SOUTHPOINTE BLVD
Mailing Address - Street 2:SUITE 235
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-8549
Mailing Address - Country:US
Mailing Address - Phone:724-941-6697
Mailing Address - Fax:724-941-7563
Practice Address - Street 1:400 SOUTHPOINTE BLVD
Practice Address - Street 2:SUITE 235
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-8549
Practice Address - Country:US
Practice Address - Phone:724-941-6697
Practice Address - Fax:724-941-7563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA074494Medicare ID - Type Unspecified