Healthcare Provider Details

I. General information

NPI: 1457315087
Provider Name (Legal Business Name): MICHAEL HEPLER-SMITH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 01/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9800A MCKNIGHT ROAD SUITE 204
PITTSBURGH PA
15237
US

IV. Provider business mailing address

2184 CHARDONNAY CIR SUITE 204
GIBSONIA PA
15044-7468
US

V. Phone/Fax

Practice location:
  • Phone: 412-366-1050
  • Fax: 412-364-7705
Mailing address:
  • Phone: 412-366-1050
  • Fax: 412-364-7705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD026103E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: