Healthcare Provider Details

I. General information

NPI: 1780850545
Provider Name (Legal Business Name): WESTERN PENNSYLVANIA FAMILY MEDICINE ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2008
Last Update Date: 04/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2057 ROUTE 130
JEANNETTE PA
15644-3801
US

IV. Provider business mailing address

2057 ROUTE 130
JEANNETTE PA
15644-3801
US

V. Phone/Fax

Practice location:
  • Phone: 412-527-0991
  • Fax: 412-527-0990
Mailing address:
  • Phone: 412-527-0991
  • Fax: 412-527-0990

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: APRIL MCDADE
Title or Position: ENROLLMENT ANALYST
Credential:
Phone: 412-330-5220