Healthcare Provider Details

I. General information

NPI: 1689088981
Provider Name (Legal Business Name): SHANNON ALEXANDRA SOLT D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2014
Last Update Date: 07/28/2021
Certification Date: 07/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 PENN AVE 4TH FLOOR #4552
PITTSBURGH PA
15224-1334
US

IV. Provider business mailing address

4401 PENN AVE 4TH FLOOR #4552
PITTSBURGH PA
15224-1334
US

V. Phone/Fax

Practice location:
  • Phone: 412-692-7366
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberS5503
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2017-00553
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberOS021303
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: