Provider Demographics
NPI:1861454852
Name:ALVI, MUMTAZ A (MD, FACS)
Entity Type:Individual
Prefix:
First Name:MUMTAZ
Middle Name:A
Last Name:ALVI
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 LINCOLN WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WHITE OAK
Mailing Address - State:PA
Mailing Address - Zip Code:15131-1642
Mailing Address - Country:US
Mailing Address - Phone:412-678-2015
Mailing Address - Fax:412-678-1422
Practice Address - Street 1:1220 LINCOLN WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:WHITE OAK
Practice Address - State:PA
Practice Address - Zip Code:15131-1642
Practice Address - Country:US
Practice Address - Phone:412-678-2015
Practice Address - Fax:412-678-1422
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD040648L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA125684OtherAETNA
PA488128OtherHIGHMARK BC/BS
PA1455317OtherUMWA
PA0012863790007Medicaid
WV3810004560Medicaid
PA0279038OtherBC/BS
PA1003957OtherGATEWAY
PA41427OtherHEALTH AMERICA/ASSURANCE
PA0012863790002Medicaid
PA61127OtherUNISON
PA1003957OtherGATEWAY
PA0012863790007Medicaid