Provider Demographics
NPI:1295156958
Name:UNIVERSITY OF PITTSBURGH MEDICAL CENTER
Entity type:Organization
Organization Name:UNIVERSITY OF PITTSBURGH MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PULMONARY MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:O
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-687-3355
Mailing Address - Street 1:11057 HUNTERS WOODS LANE
Mailing Address - Street 2:
Mailing Address - City:NORTH HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:15642
Mailing Address - Country:US
Mailing Address - Phone:412-916-6008
Mailing Address - Fax:412-623-5990
Practice Address - Street 1:5115 CENTRE AVENUE
Practice Address - Street 2:AG70.15 PREVENTION AND EARLY DETECTION SUITE
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1940
Practice Address - Country:US
Practice Address - Phone:412-634-6901
Practice Address - Fax:412-623-5990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-26
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP004331B261QR1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA$$$$$$$$$OtherSOCIAL SECURITY