Provider Demographics
NPI: | 1548427446 |
---|---|
Name: | UCHIN, JEFFREY MICHAEL (MD) |
Entity Type: | Individual |
Prefix: | DR |
First Name: | JEFFREY |
Middle Name: | MICHAEL |
Last Name: | UCHIN |
Suffix: | |
Gender: | M |
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: | 320 E NORTH AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | PITTSBURGH |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 15212-4756 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 412-359-6886 |
Mailing Address - Fax: | 412-359-3598 |
Practice Address - Street 1: | 320 E NORTH AVE |
Practice Address - Street 2: | |
Practice Address - City: | PITTSBURGH |
Practice Address - State: | PA |
Practice Address - Zip Code: | 15212-4756 |
Practice Address - Country: | US |
Practice Address - Phone: | 412-359-6886 |
Practice Address - Fax: | 412-359-3598 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2008-05-19 |
Last Update Date: | 2020-10-02 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
OH | 57.012325 | 207ZP0102X |
PA | MD439123 | 207ZP0101X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207ZP0101X | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology |
No | 207ZP0102X | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
PA | 102832986 | Medicaid | |
PA | 102832986 | Medicaid |