Provider Demographics
NPI:1558557058
Name:JOOP OFFERMAN, MD
Entity Type:Organization
Organization Name:JOOP OFFERMAN, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:L
Authorized Official - Last Name:OFFERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-361-4960
Mailing Address - Street 1:6740 REYNOLDS ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-4512
Mailing Address - Country:US
Mailing Address - Phone:412-361-4960
Mailing Address - Fax:412-361-3378
Practice Address - Street 1:6740 REYNOLDS ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-4512
Practice Address - Country:US
Practice Address - Phone:412-361-4960
Practice Address - Fax:412-361-3378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039873L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA519795Medicare PIN