Organization
OHIO VALLEY ANESTHESIA PAIN MANAGEMENT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID PROVENZANO MD (PRESIDENT)
(412) 937-5944
Entity
Organization
Contact information
Practice address
500 PINE HOLLOW RD, MC KEES ROCKS, PA 15136-1683
(412) 777-6400
(412) 777-6376
Mailing address
PO BOX 49, PITTSBURGH, PA 15230-0049
(412) 937-5700
(412) 937-5739
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1017878770001
—
PA
01
—
1920241
BLUE SHIELD
PA
Enumeration date
12/20/2006
Last updated
11/27/2007
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