| Primary Care Northside | |
|
490 E North Ave Ste 200 Pittsburgh PA 15212-4740 | |
| (412) 321-8882 | |
| (412) 321-0870 |
| Full Name | Primary Care Northside |
|---|---|
| Speciality | Internal Medicine |
| Location | 490 E North Ave Ste 200, Pittsburgh, Pennsylvania |
| Authorized Official Name and Position | Lynn Chilton (PROVIDER CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 4123305852 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Northside 4 Allegheny Ctr Fl 7 Pittsburgh PA 15212-5255 Ph: (412) 330-5861 | Primary Care Northside 490 E North Ave Ste 200 Pittsburgh PA 15212-4740 Ph: (412) 321-8882 |
| NPI Number | 1235565219 |
|---|---|
| Provider Enumeration Date | 09/23/2013 |
| Last Update Date | 11/06/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235565219 | NPI | - | NPPES |
| 100731714 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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