Basic Information
Provider Information
NPI: 1083146369
EntityType: 2
ReplacementNPI:  
OrganizationName: BUTLER HEALTH SYSTEM/ UPMC OB/GYN JOINT VENTURE, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
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Credential:  
OtherOrganizationName: ADVANCED OB/GYN ASSOCIATES
OtherOrganizationType: 5
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2 HOT METAL STREET
Address2:  
City: PITTSBURGH
State: PA
PostalCode: 152032348
CountryCode: US
TelephoneNumber: 4126473087
FaxNumber: 4126474486
Practice Location
Address1: 901 E BRADY ST
Address2: SUITE 100
City: BUTLER
State: PA
PostalCode: 160014648
CountryCode: US
TelephoneNumber: 7242859200
FaxNumber: 7242859288
Other Information
ProviderEnumerationDate: 03/28/2017
LastUpdateDate: 07/19/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: DEVLIN
AuthorizedOfficialFirstName: PATTRICIA
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: DIRECTOR
AuthorizedOfficialTelephone: 4124327469
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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