Provider Demographics
NPI:1750433074
Name:PREFERRED PRIMARY CARE PHYSICIANS
Entity type:Organization
Organization Name:PREFERRED PRIMARY CARE PHYSICIANS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-531-2902
Mailing Address - Street 1:1910 COCHRAN RD
Mailing Address - Street 2:SUITE 490
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-1203
Mailing Address - Country:US
Mailing Address - Phone:412-531-2902
Mailing Address - Fax:
Practice Address - Street 1:1168 WASHINGTON PIKE
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-2828
Practice Address - Country:US
Practice Address - Phone:412-257-0260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA197312JFZMedicare ID - Type Unspecified
PAB41111Medicare UPIN