Healthcare Provider Details
I. General information
NPI: 1114910197
Provider Name (Legal Business Name): BRYAN ROBERTSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/25/2005
Last Update Date: 06/05/2022
Certification Date: 06/05/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
UPMC HEART AND VASCULAR INSTITUTE 1350 LOCUST ST, FL 1, SUITE 100
PITTSBURGH PA
15219
US
IV. Provider business mailing address
UPMC HEART AND VASCULAR INSTITUTE 3600 MEYRAN AVENUE, FORBES TOWER, SUITE 9055
PITTSBURGH PA
15213
US
V. Phone/Fax
- Phone: 412-232-9030
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | MD421123 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RI0011X |
| Taxonomy | Interventional Cardiology Physician |
| License Number | MD421123 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: