Organization
ALLEGHENY CLINIC
Active
Other names
AHN Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY WALTEMIRE (PROVIDER ENROLLMENT SPECIALIST)
(412) 330-5864
Entity
Organization
Contact information
Practice address
490 E NORTH AVE, SUITE 107, PITTSBURGH, PA 15212-4740
(412) 359-3376
(412) 359-5094
Mailing address
490 E NORTH AVE, SUITE 107, PITTSBURGH, PA 15212-4740
(412) 359-3376
(412) 359-5094
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
MD451018
PA
207ND0900X
Dermatopathology Physician
MD451018
PA
207NS0135X
Procedural Dermatology Physician
MD451018
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007317140098
—
PA
05
—
3810010214
—
WV
Enumeration date
07/26/2005
Last updated
10/14/2020
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