Healthcare Provider Details

I. General information

NPI: 1538140546
Provider Name (Legal Business Name): SUSANNE C HARTMANN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 04/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 LOCUST ST SUITE G102 BUILDING C
PITTSBURGH PA
15219-4738
US

IV. Provider business mailing address

1518 FORBES AVE
PITTSBURGH PA
15219-5112
US

V. Phone/Fax

Practice location:
  • Phone: 412-232-8494
  • Fax: 412-232-8727
Mailing address:
  • Phone: 412-232-5546
  • Fax: 412-232-5548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberMD421450
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberMD421450
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: