Healthcare Provider Details

I. General information

NPI: 1841379286
Provider Name (Legal Business Name): HARVEY D. SHIPKOVITZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2006
Last Update Date: 02/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1312 FEDERAL ST
PITTSBURGH PA
15212-4706
US

IV. Provider business mailing address

590 OLD MILL RD
PITTSBURGH PA
15238-1918
US

V. Phone/Fax

Practice location:
  • Phone: 412-321-0255
  • Fax: 412-321-3452
Mailing address:
  • Phone: 412-963-1370
  • Fax: 412-963-6245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberMD015126E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: