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General NPI Number Information
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NPI Number | 1912028846
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Entity Type | Organization
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Legal Business Name | UPMC COMMUNITY MEDICINE INC
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 09/05/2007
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Provider Practice Location Address
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Address Line | 428 S MAIN ST
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City | GREENVILLE
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State | PA
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Zip | 16125-1748
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Country | US
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Telephone | 724-588-6660
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Fax |
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Provider Business Mailing Address
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Address Line | 428 S MAIN ST
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City | GREENVILLE
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State | PA
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Zip | 16125-1748
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Country | US
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Telephone | 724-588-6660
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MARK EHALT
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Credential |
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Telephone | 412-647-0943
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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