Healthcare Provider Details

I. General information

NPI: 1972536985
Provider Name (Legal Business Name): CARDIOVASCULAR DISEASE SPECIALISTS OF PITTSBURGH, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 03/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5750 CENTRE AVENUE SUITE 510
PITTSBURGH PA
15206
US

IV. Provider business mailing address

5750 CENTRE AVENUE SUITE 510
PITTSBURGH PA
15206
US

V. Phone/Fax

Practice location:
  • Phone: 412-924-1100
  • Fax: 412-924-1111
Mailing address:
  • Phone: 412-924-1100
  • Fax: 412-924-1111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: JACK ERNEST SMITH
Title or Position: VICE PRESIDENT
Credential: MD
Phone: 412-469-7788