Healthcare Provider Details

I. General information

NPI: 1740538578
Provider Name (Legal Business Name): ROBERT POWELL MS, ACSM-CES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2012
Last Update Date: 08/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 HOT METAL ST QUANTUM 1 BUILDING, SUITE E290
PITTSBURGH PA
15203-2348
US

IV. Provider business mailing address

804 VICTORY DR
ALLISON PARK PA
15101-4155
US

V. Phone/Fax

Practice location:
  • Phone: 412-864-0168
  • Fax:
Mailing address:
  • Phone: 724-944-8280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: