Healthcare Provider Details

I. General information

NPI: 1003366345
Provider Name (Legal Business Name): ALLEGHENY MEDICAL P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2016
Last Update Date: 10/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 CLIFFMINE RD PKW 2 SUITE
PITTSBURGH PA
15275-1008
US

IV. Provider business mailing address

2000 CLIFFMINE RD PKW 2 SUITE
PITTSBURGH PA
15275-1008
US

V. Phone/Fax

Practice location:
  • Phone: 412-494-4550
  • Fax: 412-494-6094
Mailing address:
  • Phone: 412-494-4550
  • Fax: 412-494-6094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MR. GREGORY THOMAS SHANK
Title or Position: PROVIDER
Credential: CRNP
Phone: 412-494-4550