Provider Demographics
NPI:1639184567
Name:UPMC ST MARGARET
Entity Type:Organization
Organization Name:UPMC ST MARGARET
Other - Org Name:UPMC LAWRENCEVILLE FAMILY HEALTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:VP FINACE/CFO
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DORUNDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-784-4235
Mailing Address - Street 1:3937 BUTLER ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15201-3222
Mailing Address - Country:US
Mailing Address - Phone:412-622-7343
Mailing Address - Fax:412-621-8235
Practice Address - Street 1:3937 BUTLER ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15201-3222
Practice Address - Country:US
Practice Address - Phone:412-622-7343
Practice Address - Fax:412-621-8235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2007-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA067209Medicare PIN
PA067209Medicare ID - Type Unspecified