Healthcare Provider Details

I. General information

NPI: 1740715010
Provider Name (Legal Business Name): SEAN PATRICK CARNAHAN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2017
Last Update Date: 06/17/2021
Certification Date: 06/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 FREEPORT RD. PRIMARY CARE SPORTS MEDICINE FELLOWSHIP
PITTSBURGH PA
15215
US

IV. Provider business mailing address

3600 FORBES AVENUE FORBES TOWER-PLAZA LEVEL SUITE 140
PITTSBURGH PA
15213
US

V. Phone/Fax

Practice location:
  • Phone: 412-784-4227
  • Fax: 215-481-3013
Mailing address:
  • Phone: 215-481-2725
  • Fax: 215-481-3013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOT017649
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: