Provider Demographics
NPI:1396474912
Name:REDWOOD MEDICAL PLLC
Entity type:Organization
Organization Name:REDWOOD MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:REING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-738-0965
Mailing Address - Street 1:7232 BUTLER ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-1030
Mailing Address - Country:US
Mailing Address - Phone:412-738-0965
Mailing Address - Fax:
Practice Address - Street 1:1789 S BRADDOCK AVE STE 550
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15218-1880
Practice Address - Country:US
Practice Address - Phone:412-738-0965
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty