Healthcare Provider Details

I. General information

NPI: 1821525429
Provider Name (Legal Business Name): KEITH ALLEN DUFENDACH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2017
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 LOTHROP ST
PITTSBURGH PA
15213-2582
US

IV. Provider business mailing address

200 LOTHROP ST
PITTSBURGH PA
15213-2582
US

V. Phone/Fax

Practice location:
  • Phone: 412-648-2000
  • Fax: 412-648-6358
Mailing address:
  • Phone: 412-648-2000
  • Fax: 412-648-6358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberMD495598
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: