Healthcare Provider Details

I. General information

NPI: 1992761308
Provider Name (Legal Business Name): UNIVERSITY OF PITTSBURGH PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 10/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 LOTHROP ST 9048A FORBES TOWER
PITTSBURGH PA
15213-2546
US

IV. Provider business mailing address

200 LOTHROP ST 9048A FORBES TOWER
PITTSBURGH PA
15213-2546
US

V. Phone/Fax

Practice location:
  • Phone: 412-647-0943
  • Fax:
Mailing address:
  • Phone: 412-647-0943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MARK EHALT
Title or Position: DIRECTOR, REVENUE CYCLE
Credential:
Phone: 412-647-0943