Provider Demographics
NPI:1316191224
Name:UNIVERSITY OF PITTSBURGH PHYSICIANS
Entity Type:Organization
Organization Name:UNIVERSITY OF PITTSBURGH PHYSICIANS
Other - Org Name:HEALTH CENTER ASSOCIATES-UPMC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:EHALT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-647-0943
Mailing Address - Street 1:2585 FREEPORT RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-1425
Mailing Address - Country:US
Mailing Address - Phone:866-463-1656
Mailing Address - Fax:
Practice Address - Street 1:2585 FREEPORT RD
Practice Address - Street 2:SUITE 202
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-1425
Practice Address - Country:US
Practice Address - Phone:866-463-1656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA026196Medicare PIN