Provider Demographics
NPI:1386909588
Name:UNIVERSITY OF PITTSBURGH MEDICAL CENTER (UPMC)
Entity type:Organization
Organization Name:UNIVERSITY OF PITTSBURGH MEDICAL CENTER (UPMC)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MUSTAPHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAOUADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-230-8115
Mailing Address - Street 1:107 HODIL TER
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-1109
Mailing Address - Country:US
Mailing Address - Phone:413-230-8115
Mailing Address - Fax:412-647-1999
Practice Address - Street 1:107 HODIL TER
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-1109
Practice Address - Country:US
Practice Address - Phone:413-230-8115
Practice Address - Fax:412-647-1999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-12
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT202937281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1598906802OtherSURGICAL RESIDENT BOSTON MASSACHUSETTS