Provider Demographics
NPI:1902202286
Name:ADVANCED INTEGRATIVE MEDICAL 360
Entity Type:Organization
Organization Name:ADVANCED INTEGRATIVE MEDICAL 360
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUBYAK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:412-366-3363
Mailing Address - Street 1:9365 MCKNIGHT RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5958
Mailing Address - Country:US
Mailing Address - Phone:412-366-3363
Mailing Address - Fax:
Practice Address - Street 1:9365 MCKNIGHT RD
Practice Address - Street 2:SUITE 500
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5956
Practice Address - Country:US
Practice Address - Phone:412-366-3363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-13
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044592E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty