Healthcare Provider Details

I. General information

NPI: 1104027051
Provider Name (Legal Business Name): DAVID OWEN HEPPS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 04/19/2021
Certification Date: 03/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5750 CENTRE AVE SUITE 395
PITTSBURGH PA
15206-3721
US

IV. Provider business mailing address

1000 BOWER HILL ROAD ST CLAIR HOSPITAL - AFFILIATE BILLING - PAMALYN
PITTSBURGH PA
15243-1873
US

V. Phone/Fax

Practice location:
  • Phone: 412-661-3400
  • Fax: 412-661-5885
Mailing address:
  • Phone: 412-942-2548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number23314
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberMD433985
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: