Healthcare Provider Details

I. General information

NPI: 1497721146
Provider Name (Legal Business Name): JAMES W BACKSTROM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 LIBERTY AVE STE 2000 THREE GATEWAY CENTER, 20TH FLOOR
PITTSBURGH PA
15222-1029
US

IV. Provider business mailing address

401 LIBERTY AVE STE 2000
PITTSBURGH PA
15222-1029
US

V. Phone/Fax

Practice location:
  • Phone: 412-223-2272
  • Fax: 412-281-6320
Mailing address:
  • Phone: 412-230-8200
  • Fax: 412-202-8638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number0101040755
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0101040755
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD418526
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: