Healthcare Provider Details

I. General information

NPI: 1053386516
Provider Name (Legal Business Name): ERIC S QUIVERS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2006
Last Update Date: 09/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3414 5TH AVE CHOB BUILDING, 1ST FLOOR
PITTSBURGH PA
15213-3205
US

IV. Provider business mailing address

3414 5TH AVE CHOB BUILDING, 1ST FLOOR
PITTSBURGH PA
15213-3205
US

V. Phone/Fax

Practice location:
  • Phone: 412-692-5540
  • Fax:
Mailing address:
  • Phone: 412-692-5540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberMD425250
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: