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General NPI Number Information
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NPI Number | 1760743843
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Entity Type | Individual
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Provider Name | ANDREW PROUT M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/05/2012
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Last Update Date | 03/23/2022
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Provider Practice Location Address
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Address Line | 3550 TERRACE ST
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City | PITTSBURGH
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State | PA
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Zip | 15213-2500
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Country | US
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Telephone | 412-647-3136
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Fax | 412-647-8060
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Provider Business Mailing Address
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Address Line | 3550 TERRACE ST
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City | PITTSBURGH
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State | PA
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Zip | 15213-2500
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Country | US
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Telephone | 412-647-3136
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Fax | 412-647-8060
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 4301100912
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | 4301501340
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License Number State | MI
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