Healthcare Provider Details

I. General information

NPI: 1245232115
Provider Name (Legal Business Name): MYLES H ZUCKERMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 10/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 BALDWICK RD
PITTSBURGH PA
15205-4140
US

IV. Provider business mailing address

50 MOFFETT ST
PITTSBURGH PA
15243-1162
US

V. Phone/Fax

Practice location:
  • Phone: 412-922-6262
  • Fax: 412-922-5026
Mailing address:
  • Phone: 412-572-8823
  • Fax: 412-572-8755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD033411-E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: