Provider Demographics
NPI:1760086763
Name:ST CLAIR MEDICAL SERVICES, INC.
Entity Type:Organization
Organization Name:ST CLAIR MEDICAL SERVICES, INC.
Other - Org Name:ST. CLAIR MEDICAL GROUP UROLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:PAMALYN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATNESKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-942-2548
Mailing Address - Street 1:1000 BOWER HILL ROAD
Mailing Address - Street 2:ATTN PAMALYN PATNESKY
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1873
Mailing Address - Country:US
Mailing Address - Phone:412-942-2548
Mailing Address - Fax:
Practice Address - Street 1:1000 BOWER HILL RD STE 7600
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1873
Practice Address - Country:US
Practice Address - Phone:412-942-4100
Practice Address - Fax:412-942-4122
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. CLAIR HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-30
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty