Organization
NORTH SHORE AMBULATORY SURGICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK E DEMOS M.D. (OWNER)
(412) 231-0200
Entity
Organization
Contact information
Practice address
2 ALLEGHENY CTR, PITTSBURGH, PA 15212-5402
(412) 231-0200
(412) 231-0613
Mailing address
2 ALLEGHENY CTR, PITTSBURGH, PA 15212-5402
(412) 231-0200
(412) 231-0613
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
4271500
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0164
BLUE SHIELD
PA
Enumeration date
01/17/2006
Last updated
08/22/2020
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