Provider Demographics
NPI:1316205958
Name:ST. CLAIR WASHINGTON PHYSICIAN SERVICES
Entity Type:Organization
Organization Name:ST. CLAIR WASHINGTON PHYSICIAN SERVICES
Other - Org Name:SOUTHWESTERN PA ASSOCIATES IN NEUROLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VP & CFO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHESNOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-942-1250
Mailing Address - Street 1:1000 BOWER HILL RD
Mailing Address - Street 2:AFFILIATE BILLING
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1873
Mailing Address - Country:US
Mailing Address - Phone:412-942-2674
Mailing Address - Fax:412-942-2689
Practice Address - Street 1:101 TRICH DR STE 1
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-5989
Practice Address - Country:US
Practice Address - Phone:724-228-4011
Practice Address - Fax:724-228-7293
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. CLAIR HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-02
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty