Healthcare Provider Details

I. General information

NPI: 1881692697
Provider Name (Legal Business Name): LOUIS M CERTO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 11/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CHAPEL HARBOR DR SUITE 102
PITTSBURGH PA
15238-4131
US

IV. Provider business mailing address

304 WAINWRIGHT DR
NORTHBROOK IL
60062-1900
US

V. Phone/Fax

Practice location:
  • Phone: 412-356-0110
  • Fax: 224-235-4652
Mailing address:
  • Phone: 847-593-8460
  • Fax: 224-235-8460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35-07-4596C
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD039604L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: