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General NPI Number Information
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NPI Number | 1023060779
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Entity Type | Organization
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Legal Business Name | PLASTIC SURGICAL ASSOCIATES OF PITTSBURGH, P.C.
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 02/18/2016
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Provider Practice Location Address
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Address Line | 1050 BOWER HILL RD SUITE 105
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City | PITTSBURGH
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State | PA
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Zip | 15243-1800
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Country | US
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Telephone | 412-572-6164
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Fax | 412-572-6156
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Provider Business Mailing Address
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Address Line | PO BOX 719
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City | MONROEVILLE
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State | PA
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Zip | 15146-0719
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Country | US
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Telephone | 412-457-0175
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Fax | 412-457-0179
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT W BRAGDON
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Credential | MD
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Telephone | 412-572-6164
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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