Healthcare Provider Details

I. General information

NPI: 1407196165
Provider Name (Legal Business Name): ST. CLAIR MEDICAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2013
Last Update Date: 02/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1626 POTOMAC AVE
PITTSBURGH PA
15216-1947
US

IV. Provider business mailing address

1000 BOWER HILL RD AFFILIATE BILLING
PITTSBURGH PA
15243-1873
US

V. Phone/Fax

Practice location:
  • Phone: 412-531-7020
  • Fax: 412-531-2260
Mailing address:
  • Phone: 412-942-2533
  • Fax: 412-942-2589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD C. CHESNOS
Title or Position: SR VP & CFO
Credential:
Phone: 412-942-1250