Basic Information
Provider Information
NPI: 1396843835
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CORTINOVIS
FirstName: CHARLES
MiddleName: RICHARD
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 LOTHROP STREET
Address2: FORBES TOWER SUITE 9055
City: PITTSBURGH
State: PA
PostalCode: 15213
CountryCode: US
TelephoneNumber: 4126473087
FaxNumber: 4126474486
Practice Location
Address1: 1500 FIFTH AVENUE
Address2:  
City: MCKEESPORT
State: PA
PostalCode: 15132
CountryCode: US
TelephoneNumber: 4126739077
FaxNumber: 4126642658
Other Information
ProviderEnumerationDate: 09/20/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XMD019406EPAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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