MEDICARE: DR. MIRIAM TEITELBAUM DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	OS017659	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	13596448	OTHER	PA	CAQH

General Provider Information

NPI Number	:	1811251887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MIRIAM TEITELBAUM DO

Provider Business Mailing Address
First Line	:	5889 FORBES AVENUE
Second Line	:	SUITE 200
City	:	PITTSBURGH
State	:	PA
Zip	:	15217-4601
Country	:	US
Telephone Number	:	412-618-3010
Fax Number	:	412-618-3011

Provider Business Practice Location Address
First Line	:	5889 FORBES AVENUE
Second Line	:	SUITE 200
City	:	PITTSBURGH
State	:	PA
Zip	:	15217-4601
Country	:	US
Telephone Number	:	412-618-3010
Fax Number	:	412-618-3011

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2012
Last Update Date	:	04/13/2016

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Directions to “ DR. MIRIAM TEITELBAUM DO” Practice Location

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