Healthcare Provider Details

I. General information

NPI: 1225195274
Provider Name (Legal Business Name): WAYNE A CHRISTOPHERSON & ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 08/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 LOCUST ST SUITE 3121
PITTSBURGH PA
15219-5114
US

IV. Provider business mailing address

1400 LOCUST ST SUITE 3121
PITTSBURGH PA
15219-5114
US

V. Phone/Fax

Practice location:
  • Phone: 412-621-6464
  • Fax: 412-232-3175
Mailing address:
  • Phone: 412-621-6464
  • Fax: 412-232-3175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberMD033040E
License Number StatePA

VIII. Authorized Official

Name: DR. WAYNE A CHRISTOPHERSON
Title or Position: PHYSICIAN
Credential: MD
Phone: 412-621-6464