Healthcare Provider Details
I. General information
NPI: 1912457185
Provider Name (Legal Business Name): UPMC COMMUNITY MEDICINE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/11/2016
Last Update Date: 10/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1432 LINCOLN WAY SUITE 101
WHITE OAK PA
15131-1600
US
IV. Provider business mailing address
1432 LINCOLN WAY SUITE 101
WHITE OAK PA
15131-1600
US
V. Phone/Fax
- Phone: 412-672-3633
- Fax: 412-672-3810
- Phone: 412-672-3633
- Fax: 412-672-3810
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MOLLY
CALDWELL
Title or Position: SR. MANAGER
Credential:
Phone: 412-432-5846