Provider Demographics
NPI:1093887887
Name:MUMTAZ A. ALVI, M.D., P.C.
Entity Type:Organization
Organization Name:MUMTAZ A. ALVI, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:JAMI
Authorized Official - Middle Name:
Authorized Official - Last Name:MOODY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-929-8411
Mailing Address - Street 1:1220 LINCOLN WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MCKEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15131-1642
Mailing Address - Country:US
Mailing Address - Phone:412-678-2015
Mailing Address - Fax:412-678-1422
Practice Address - Street 1:1220 LINCOLN WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15131-1642
Practice Address - Country:US
Practice Address - Phone:412-678-2015
Practice Address - Fax:412-678-1422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012863790007Medicaid
PA015018Medicare PIN
PAF41427Medicare UPIN
PA0012863790007Medicaid