Basic Information
Provider Information
NPI: 1013017029
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCLANE
FirstName: MELISSA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2 HOT METAL ST
Address2: QUANTUM ONE
City: PITTSBURGH
State: PA
PostalCode: 152032348
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 8000 CRANBERRY SPRINGS DR
Address2: SUITE 100
City: CRANBERRY TOWNSHIP
State: PA
PostalCode: 160666687
CountryCode: US
TelephoneNumber: 7247203000
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/22/2006
LastUpdateDate: 03/25/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207PS0010XOS010610LPAY Allopathic & Osteopathic PhysiciansEmergency MedicineSports Medicine

No ID Information.


Home