1861454852 NPI number — MUMTAZ A ALVI MD, FACS

Table of content: MUMTAZ A ALVI MD, FACS (NPI 1861454852)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861454852 NPI number — MUMTAZ A ALVI MD, FACS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALVI
Provider First Name:
MUMTAZ
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD, FACS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861454852
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/27/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1220 LINCOLN WAY
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
WHITE OAK
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15131-1642
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-678-2015
Provider Business Mailing Address Fax Number:
412-678-1422

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1220 LINCOLN WAY
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
WHITE OAK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15131-1642
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-678-2015
Provider Business Practice Location Address Fax Number:
412-678-1422
Provider Enumeration Date:
04/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  MD040648L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 125684 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 488128 . This is a "HIGHMARK BC/BS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1455317 . This is a "UMWA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0012863790007 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3810004560 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0279038 . This is a "BC/BS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1003957 . This is a "GATEWAY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 41427 . This is a "HEALTH AMERICA/ASSURANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0012863790002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 61127 . This is a "UNISON" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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