Provider Demographics
NPI:1881145282
Name:ST. CLAIR MEDICAL SERVICES INC.
Entity type:Organization
Organization Name:ST. CLAIR MEDICAL SERVICES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR. VP & CFO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHESNOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-942-1250
Mailing Address - Street 1:2000 OXFORD DR
Mailing Address - Street 2:SUITE 302
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-1827
Mailing Address - Country:US
Mailing Address - Phone:412-854-5491
Mailing Address - Fax:
Practice Address - Street 1:2000 OXFORD DR
Practice Address - Street 2:SUITE 302
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102-1827
Practice Address - Country:US
Practice Address - Phone:412-854-5491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA450501207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty