Provider Demographics
NPI:1639100852
Name:SOUTH HILLS ENT ASSOCIATION
Entity Type:Organization
Organization Name:SOUTH HILLS ENT ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:DEMARINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-831-7570
Mailing Address - Street 1:2000 OXFORD DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-1827
Mailing Address - Country:US
Mailing Address - Phone:412-831-7570
Mailing Address - Fax:412-854-6149
Practice Address - Street 1:2000 OXFORD DR
Practice Address - Street 2:SUITE 201
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102-1827
Practice Address - Country:US
Practice Address - Phone:412-831-7570
Practice Address - Fax:412-854-6149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA=========OtherTAX IDENTIFICATION
PA=========OtherTAX IDENTIFICATION