Provider Demographics
NPI:1104027051
Name:HEPPS, DAVID OWEN (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:OWEN
Last Name:HEPPS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1000 BOWER HILL ROAD
Mailing Address - Street 2:ST CLAIR HOSPITAL - AFFILIATE BILLING - PAMALYN
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1873
Mailing Address - Country:US
Mailing Address - Phone:412-942-2548
Mailing Address - Fax:
Practice Address - Street 1:5750 CENTRE AVE
Practice Address - Street 2:SUITE 395
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-3721
Practice Address - Country:US
Practice Address - Phone:412-661-3400
Practice Address - Fax:412-661-5885
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV23314208800000X
PAMD433985208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV4243401Medicare PIN
PA128446KLSMedicare PIN