Provider Demographics
NPI:1861936841
Name:METRO FAMILY PRACTICE INC.
Entity type:Organization
Organization Name:METRO FAMILY PRACTICE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:TRAMAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-342-4044
Mailing Address - Street 1:1789 S BRADDOCK AVE
Mailing Address - Street 2:SUITE 410
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15218-1842
Mailing Address - Country:US
Mailing Address - Phone:412-247-2310
Mailing Address - Fax:412-247-2373
Practice Address - Street 1:1789 S BRADDOCK AVE
Practice Address - Street 2:SUITE 410
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15218-1842
Practice Address - Country:US
Practice Address - Phone:412-247-2310
Practice Address - Fax:412-247-2373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016548870005Medicaid
PA1028871330003Medicaid
PA0010967590004Medicaid
PA1028651810001Medicaid
PA1029366770001Medicaid
PA1007280020007Medicaid
PA0016549020005Medicaid