1275885428 NPI number — UPMC COMMUNITY MEDICINE INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275885428 NPI number — UPMC COMMUNITY MEDICINE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UPMC COMMUNITY MEDICINE INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
INFECTIOUS DISEASE ASSOCIATES OF WESTERN PENNSYLVANIA-UPMC
Provider Other Organization Name Type Code:
3
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:
1275885428
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/12/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
580 S AIKEN AVE
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15232-1531
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-687-5040
Provider Business Mailing Address Fax Number:
412-687-5044

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
580 S AIKEN AVE
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15232-1531
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-687-5040
Provider Business Practice Location Address Fax Number:
412-687-5044
Provider Enumeration Date:
10/12/2012

Additional Information

Authorized Official

Authorized Official Last Name:
EHALT
Authorized Official First Name:
MARK
Authorized Official Middle Name:
Authorized Official Title or Position:
SR. DIRECTOR
Authorized Official Telephone Number:
412-647-0943

Provider Taxonomy Codes

  • Taxonomy code: 207RI0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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