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NPI Code Detail

MEDICARE: UPMC COMMUNITY MEDICINE INC

MEDICARE: UPMC COMMUNITY MEDICINE INC
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1891939328
Entity Type Code : Organization
Provider Name (Legal Business Name) : UPMC COMMUNITY MEDICINE INC
Provider Business Mailing Address
First Line : 20630 ROUTE 19
Second Line : SUITE 101
City : CRANBERRY TOWNSHIP
State : PA
Zip : 16066-6021
Country : US
Telephone Number : 412-855-8462
Fax Number :
Provider Business Practice Location Address
First Line : 20630 ROUTE 19
Second Line : SUITE 101
City : CRANBERRY TOWNSHIP
State : PA
Zip : 16066-6021
Country : US
Telephone Number : 412-855-8462
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : MR. MARK EHALT
Credential :
Telephone Number : 412-647-0943
Provider Enumeration Date : 04/28/2009
Last Update Date : 04/28/2009

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Directions to “UPMC COMMUNITY MEDICINE INC ” Practice Location

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