Healthcare Provider Details

I. General information

NPI: 1184003527
Provider Name (Legal Business Name): MAX HURWITZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2015
Last Update Date: 09/08/2022
Certification Date: 09/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3471 5TH AVE
PITTSBURGH PA
15213-3215
US

IV. Provider business mailing address

1400 LOCUST ST STE G-103
PITTSBURGH PA
15219-5114
US

V. Phone/Fax

Practice location:
  • Phone: 206-685-0936
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberOL60643074
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberOS020708
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: