Healthcare Provider Details

I. General information

NPI: 1508830159
Provider Name (Legal Business Name): AMAL I KANBOUR MD,PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: AMAL I KANBOUR-SHAKIR MD,PHD

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 04/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HALKET ST
PITTSBURGH PA
15213-3108
US

IV. Provider business mailing address

300 HALKET ST
PITTSBURGH PA
15213-3108
US

V. Phone/Fax

Practice location:
  • Phone: 412-641-5400
  • Fax:
Mailing address:
  • Phone: 412-641-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD034750E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberMD034750E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: