Healthcare Provider Details

I. General information

NPI: 1275604142
Provider Name (Legal Business Name): YRAM J. GROFF, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 06/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4815 LIBERTY AVE SUITE 250
PITTSBURGH PA
15224-2156
US

IV. Provider business mailing address

510 S AIKEN AVE STE EG-01 EAST WING SHADYSIDE HOSPITAL
PITTSBURGH PA
15232-1505
US

V. Phone/Fax

Practice location:
  • Phone: 412-683-1717
  • Fax: 412-683-1773
Mailing address:
  • Phone: 412-683-1717
  • Fax: 412-683-1773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD063920L
License Number StatePA

VIII. Authorized Official

Name: DR. YRAM JAN GROFF
Title or Position: PRESIDENT
Credential: MD
Phone: 412-683-1717