Provider Demographics
NPI:1326174434
Name:UPMC COMMUNITY MEDICINE INC
Entity Type:Organization
Organization Name:UPMC COMMUNITY MEDICINE INC
Other - Org Name:CRAIG MEDICAL ASSOC 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 1:6301 FORBES AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-1725
Mailing Address - Country:US
Mailing Address - Phone:412-422-5970
Mailing Address - Fax:412-422-5278
Practice Address - Street 1:6301 FORBES AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-1725
Practice Address - Country:US
Practice Address - Phone:412-422-5970
Practice Address - Fax:412-422-5278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-25
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA042490Medicare PIN