Healthcare Provider Details

I. General information

NPI: 1174659502
Provider Name (Legal Business Name): UPMC COMMUNITY MEDICINE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 11/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 BROWNSVILLE RD
PITTSBURGH PA
15227-2469
US

IV. Provider business mailing address

3000 BROWNSVILLE RD
PITTSBURGH PA
15227-2469
US

V. Phone/Fax

Practice location:
  • Phone: 412-881-0320
  • Fax:
Mailing address:
  • Phone: 412-881-0320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MARK EHALT
Title or Position: DIRECTOR
Credential:
Phone: 412-647-0943