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General NPI Number Information
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NPI Number | 1295156958
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF PITTSBURGH MEDICAL CENTER
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Dates
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Enumeration Date | 12/26/2013
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Last Update Date | 05/21/2020
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Provider Practice Location Address
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Address Line | 5115 CENTRE AVENUE AG70.15 PREVENTION AND EARLY DETECTION SUITE
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City | PITTSBURGH
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State | PA
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Zip | 15232-1940
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Country | US
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Telephone | 412-634-6901
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Fax | 412-623-5990
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Provider Business Mailing Address
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Address Line | 11057 HUNTERS WOODS LANE
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City | NORTH HUNTINGDON
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State | PA
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Zip | 15642
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Country | US
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Telephone | 412-916-6008
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Fax | 412-623-5990
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Authorized Official
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Title or Position | PULMONARY MEDICINE
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Name | DR. DAVID O WILSON
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Credential | MD
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Telephone | 412-687-3355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1100X
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Taxonomy Name | Research Clinic/Center
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License Number | UP004331B
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License Number State | PA
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