Healthcare Provider Details

I. General information

NPI: 1255305918
Provider Name (Legal Business Name): STERGIOS MOSCHOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 12/16/2020
Certification Date: 12/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5115 CENTRE AVE UPMC CANCER PAVILLION
PITTSBURGH PA
15232-1301
US

IV. Provider business mailing address

PO BOX 271647
SALT LAKE CITY UT
84127-1647
US

V. Phone/Fax

Practice location:
  • Phone: 412-623-2294
  • Fax:
Mailing address:
  • Phone: 919-966-3856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number2011-01759
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: