Healthcare Provider Details

I. General information

NPI: 1114228459
Provider Name (Legal Business Name): SPECIALTIES OF PLASTIC, HAND AND MICROSURGERY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2010
Last Update Date: 11/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5750 CENTRE AVE SUITE 180
PITTSBURGH PA
15206-3721
US

IV. Provider business mailing address

5750 CENTRE AVE SUITE 180
PITTSBURGH PA
15206-3721
US

V. Phone/Fax

Practice location:
  • Phone: 412-661-5380
  • Fax: 412-661-5381
Mailing address:
  • Phone: 412-661-5380
  • Fax: 412-661-5381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number023594-E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number023594-E
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number023594-E
License Number StatePA

VIII. Authorized Official

Name: DR. WILLIAM M SWARATZ
Title or Position: OWNER
Credential: M.D.
Phone: 412-661-5380