Healthcare Provider Details

I. General information

NPI: 1861942278
Provider Name (Legal Business Name): UPMC COMMUNITY MEDICINE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2016
Last Update Date: 10/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12279 ROUTE 30
NORTH HUNTINGDON PA
15642-1876
US

IV. Provider business mailing address

12279 ROUTE 30
NORTH HUNTINGDON PA
15642-1876
US

V. Phone/Fax

Practice location:
  • Phone: 724-864-7101
  • Fax: 724-864-7160
Mailing address:
  • Phone: 724-864-7101
  • Fax: 724-864-7160

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: MARY CALDWELL
Title or Position: SR. MANAGER
Credential:
Phone: 412-432-5846