Basic Information
Provider Information
NPI: 1831571421
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SHORT
FirstName: MARGO
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3600 FORBES AVENUE
Address2: FORBES TOWER - PLAZA LEVEL SUITE 140
City: PITTSBURGH
State: PA
PostalCode: 15213
CountryCode: US
TelephoneNumber: 8163054600
FaxNumber:  
Practice Location
Address1: 3550 TERRACE STREET
Address2: SCAIFE HALL ROOM 651
City: PITTSBURGH
State: PA
PostalCode: 15261
CountryCode: US
TelephoneNumber: 4126473136
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/19/2015
LastUpdateDate: 06/11/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XR3869KYY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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