Healthcare Provider Details

I. General information

NPI: 1104968650
Provider Name (Legal Business Name): ULLA MARIA ELISABET BLIX MD, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ULLA MARIA ELISABET NYSTROM MD, PHD

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 06/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 LOTHROP ST
PITTSBURGH PA
15213-2536
US

IV. Provider business mailing address

200 LOTHROP ST FORBES TOWER SUITE 9055
PITTSBURGH PA
15213-2536
US

V. Phone/Fax

Practice location:
  • Phone: 412-647-3260
  • Fax: 412-647-0342
Mailing address:
  • Phone: 412-647-3087
  • Fax: 412-647-4486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD430451
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: