=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285887331
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STANISLAV BELYAT M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/01/2008
-----------------------------------------------------
Last Update Date | 10/30/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 320 E NORTH AVE
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15212-4756
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-359-4970
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3 ALLEGHENY CTR APT 203
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15212-5306
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-295-9889
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | MT197891
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------