Healthcare Provider Details
I. General information
NPI: 1740531946
Provider Name (Legal Business Name): ST. CLAIR MEDICAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/27/2012
Last Update Date: 09/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2500 BALDWICK RD
PITTSBURGH PA
15205-4140
US
IV. Provider business mailing address
1000 BOWER HILL RD
PITTSBURGH PA
15243-1873
US
V. Phone/Fax
- Phone: 412-922-6262
- Fax:
- Phone: 412-942-2674
- Fax: 412-942-2689
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family 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