Healthcare Provider Details

I. General information

NPI: 1821546045
Provider Name (Legal Business Name): LOW T COMPLETE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2016
Last Update Date: 09/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 OXFORD DR SUITE 440
BETHEL PARK PA
15102-1827
US

IV. Provider business mailing address

2000 OXFORD DR SUITE 440
BETHEL PARK PA
15102-1827
US

V. Phone/Fax

Practice location:
  • Phone: 412-833-2233
  • Fax: 412-833-2293
Mailing address:
  • Phone: 412-833-2233
  • Fax: 412-833-2293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMD057587L
License Number StatePA

VIII. Authorized Official

Name: DR. JOEL WARSHAW
Title or Position: CEO
Credential: M.D.
Phone: 412-833-2233