Healthcare Provider Details

I. General information

NPI: 1306847884
Provider Name (Legal Business Name): JOSE G. OLIVA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 11/18/2020
Certification Date: 11/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1307 FEDERAL ST STE B100
PITTSBURGH PA
15212-4761
US

IV. Provider business mailing address

1307 FEDERAL ST STE B100
PITTSBURGH PA
15212-4761
US

V. Phone/Fax

Practice location:
  • Phone: 412-359-8900
  • Fax: 412-359-8977
Mailing address:
  • Phone: 412-359-8900
  • Fax: 412-359-8977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RT0003X
TaxonomyTransplant Hepatology Physician
License NumberMD421287
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD421287
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: