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NPI Code Detail

MEDICARE: UPMC COMMUNITY MEDICINE INC

MEDICARE: UPMC COMMUNITY MEDICINE INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1790811842
Entity Type Code : Organization
Provider Name (Legal Business Name) : UPMC COMMUNITY MEDICINE INC
Provider Business Mailing Address
First Line : 101 ORCHARD DR
Second Line :
City : TRAFFORD
State : PA
Zip : 15085-1640
Country : US
Telephone Number : 412-856-7332
Fax Number :
Provider Business Practice Location Address
First Line : 101 ORCHARD DR
Second Line :
City : TRAFFORD
State : PA
Zip : 15085-1640
Country : US
Telephone Number : 412-856-7332
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : MARK EHALT
Credential :
Telephone Number : 412-647-0943
Provider Enumeration Date : 02/25/2007
Last Update Date : 10/02/2007

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Directions to “UPMC COMMUNITY MEDICINE INC ” Practice Location

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