Healthcare Provider Details

I. General information

NPI: 1306804729
Provider Name (Legal Business Name): UNIVERSITY OF PITTSBURGH PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 03/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 LOTHROP ST SUITE C700
PITTSBURGH PA
15213-2546
US

IV. Provider business mailing address

200 LOTHROP ST SUITE C700
PITTSBURGH PA
15213-2546
US

V. Phone/Fax

Practice location:
  • Phone: 412-647-0943
  • Fax: 412-647-4050
Mailing address:
  • Phone: 412-647-0943
  • Fax: 412-647-4050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: MARK EHALT
Title or Position: DIRECTOR, REVENUE CYCLE
Credential:
Phone: 412-647-0943