=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588039457
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | UPMC COMMUNITY MEDICINE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/03/2015
-----------------------------------------------------
Last Update Date | 12/14/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1024 W VIEW PARK DR
-----------------------------------------------------
City | WEST VIEW
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15229-1771
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-219-1180
-----------------------------------------------------
Fax | 412-219-1181
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1024 W VIEW PARK DR
-----------------------------------------------------
City | WEST VIEW
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15229-1771
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-219-1180
-----------------------------------------------------
Fax | 412-219-1181
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SR. MANAGER
-----------------------------------------------------
Name | MOLLY CALDWELL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 412-432-5846
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RE0101X
-----------------------------------------------------
Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------