Healthcare Provider Details

I. General information

NPI: 1487588943
Provider Name (Legal Business Name): UPMC COMMUNITY MEDICINE OHIO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 JOHNSON RD
STEUBENVILLE OH
43952-2364
US

IV. Provider business mailing address

600 GRANT ST FL 59
PITTSBURGH PA
15219-2740
US

V. Phone/Fax

Practice location:
  • Phone: 740-264-8110
  • Fax: 740-264-8109
Mailing address:
  • Phone: 412-623-6303
  • Fax: 412-623-6369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE JEGASOTHY
Title or Position: INCORPORATOR
Credential:
Phone: 412-647-5472