Provider Demographics
NPI:1013937358
Name:CHAMORRO, HECTOR AVELINO (MD)
Entity Type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:AVELINO
Last Name:CHAMORRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 LAVALE DR APT G2
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2930
Mailing Address - Country:US
Mailing Address - Phone:412-372-4477
Mailing Address - Fax:
Practice Address - Street 1:995 GREENTREE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15220-3242
Practice Address - Country:US
Practice Address - Phone:412-922-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD030752L2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01856256Medicaid
PA320964OtherBC/BS NUMBER
PA053236Medicare ID - Type UnspecifiedMEDICARE NUMBER