Healthcare Provider Details

I. General information

NPI: 1063244929
Provider Name (Legal Business Name): NATHANIEL ARTHUR SMITH PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2024
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9104 BABCOCK BLVD
PITTSBURGH PA
15237-5818
US

IV. Provider business mailing address

8150 PERRY HWY STE 201
PITTSBURGH PA
15237-5200
US

V. Phone/Fax

Practice location:
  • Phone: 412-931-3066
  • Fax: 412-931-2464
Mailing address:
  • Phone: 412-369-9550
  • Fax: 412-369-9566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMS9068227
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMA065846
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: