Healthcare Provider Details

I. General information

NPI: 1558098830
Provider Name (Legal Business Name): UPMC COMMUNITY MEDICINE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2022
Last Update Date: 08/05/2022
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2490 MOSSIDE BOULEVARD
MONROEVILLE PA
15146
US

IV. Provider business mailing address

2 HOT METAL STREET QUANTUM ONE BLDG
PITTSBURGH PA
15203
US

V. Phone/Fax

Practice location:
  • Phone: 412-565-7013
  • Fax:
Mailing address:
  • Phone: 141-243-2586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA DEVLIN
Title or Position: DIRECTOR
Credential:
Phone: 412-432-7469