Provider Demographics
NPI:1043285083
Name:ALLEGHENY MEDICAL PRACTICE NEETWORK
Entity Type:Organization
Organization Name:ALLEGHENY MEDICAL PRACTICE NEETWORK
Other - Org Name:FUGE FAMILY PRACTICE
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 1:300 PENN CENTER BLVD
Mailing Address - Street 2:SUITE 702
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-5511
Mailing Address - Country:US
Mailing Address - Phone:412-816-2273
Mailing Address - Fax:412-816-2329
Practice Address - Street 1:300 PENN CENTER BLVD
Practice Address - Street 2:SUITE 702
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-5511
Practice Address - Country:US
Practice Address - Phone:412-816-2273
Practice Address - Fax:412-816-2329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-22
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017600750028Medicaid
PA074494Medicare PIN
PA0017600750028Medicaid