Provider Demographics
NPI:1255318911
Name:CANFIELD, PATRICIA HOGAN (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:HOGAN
Last Name:CANFIELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 WIGHTMAN ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-1408
Mailing Address - Country:US
Mailing Address - Phone:412-795-2710
Mailing Address - Fax:412-521-5827
Practice Address - Street 1:1500 WIGHTMAN ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-1408
Practice Address - Country:US
Practice Address - Phone:412-580-4469
Practice Address - Fax:412-521-5827
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-23
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD046032L208100000X, 2081P0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0141179Medicaid
PA0141179Medicaid
PAF05238Medicare UPIN