Healthcare Provider Details

I. General information

NPI: 1568875607
Provider Name (Legal Business Name): THERSILLA OBERBARNSCHEIDT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: THERSILLA WITT M.D.

II. Dates (important events)

Enumeration Date: 06/06/2014
Last Update Date: 07/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 FORBES AVE STE 900
PITTSBURGH PA
15213
US

IV. Provider business mailing address

3501 FORBES AVE STE 900
PITTSBURGH PA
15213-3326
US

V. Phone/Fax

Practice location:
  • Phone: 517-897-0917
  • Fax:
Mailing address:
  • Phone: 517-897-0917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number5315066465
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number4301105911
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberMD463132
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: