Basic Information
Provider Information
NPI: 1003138868
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAMP
FirstName: COLIN
MiddleName: E.
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 DELAFIELD RD
Address2: UPMC CANCER CENTER AT ST. MARGARET
City: PITTSBURGH
State: PA
PostalCode: 152153205
CountryCode: US
TelephoneNumber: 4127813744
FaxNumber: 4127813744
Practice Location
Address1: 200 DELAFIELD RD
Address2: UPMC CANCER CENTER AT ST. MARGARET
City: PITTSBURGH
State: PA
PostalCode: 152153205
CountryCode: US
TelephoneNumber: 4127813744
FaxNumber: 4127813744
Other Information
ProviderEnumerationDate: 02/22/2010
LastUpdateDate: 05/28/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0001XMD448624PAY Allopathic & Osteopathic PhysiciansRadiologyRadiation Oncology

No ID Information.


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