Provider Demographics
NPI:1598195331
Name:CONTEMPORARY MEDICAL AND PHYSICAL MEDICINE LLC
Entity Type:Organization
Organization Name:CONTEMPORARY MEDICAL AND PHYSICAL MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-279-4522
Mailing Address - Street 1:2850 SAW MILL RUN BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15227-1714
Mailing Address - Country:US
Mailing Address - Phone:412-882-3300
Mailing Address - Fax:412-882-2661
Practice Address - Street 1:2275 SWALLOW HILL RD
Practice Address - Street 2:BLDG. 2600
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-1656
Practice Address - Country:US
Practice Address - Phone:412-279-4522
Practice Address - Fax:412-279-3416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD420553208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty