Provider Demographics
NPI:1043504087
Name:BUTERBAUGH, OLIVIA DAWN (PA-C)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:DAWN
Last Name:BUTERBAUGH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:DAWN
Other - Last Name:HESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:810 CLAIRTON BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-4519
Mailing Address - Country:US
Mailing Address - Phone:412-466-5004
Mailing Address - Fax:412-466-7137
Practice Address - Street 1:4070 BEECHWOOD BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-2679
Practice Address - Country:US
Practice Address - Phone:412-521-6511
Practice Address - Fax:412-521-6512
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0005912363AM0700X
PAMA054768363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical