Healthcare Provider Details

I. General information

NPI: 1164410940
Provider Name (Legal Business Name): ANKUR PURI MD, FCCP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 05/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9104 BABCOCK BLVD SUITE 2103
PITTSBURGH PA
15237-5818
US

IV. Provider business mailing address

9104 BABCOCK BLVD STE 2103
PITTSBURGH PA
15237-5818
US

V. Phone/Fax

Practice location:
  • Phone: 412-748-5020
  • Fax: 412-635-4971
Mailing address:
  • Phone: 412-748-5020
  • Fax: 412-367-3122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number436324
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number436324
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number436324
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number436324
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: