Provider Demographics
NPI:1255829032
Name:MOALE, AMANDA COPENHAVER (MD)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:COPENHAVER
Last Name:MOALE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:LEIGH
Other - Last Name:COPENHAVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 GRANT ST FL 58
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-2739
Mailing Address - Country:US
Mailing Address - Phone:410-955-5000
Mailing Address - Fax:
Practice Address - Street 1:200 LOTHROP ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2536
Practice Address - Country:US
Practice Address - Phone:412-647-2345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-26
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD473625207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease