Provider Demographics
NPI:1083601157
Name:PAUTLER, SIMONA V (MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:SIMONA
Middle Name:V
Last Name:PAUTLER
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Gender:F
Credentials:MD, FACS
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Mailing Address - Street 1:3311 WASHINGTON RD
Mailing Address - Street 2:STE 200
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-3114
Mailing Address - Country:US
Mailing Address - Phone:724-969-0930
Mailing Address - Fax:724-969-0428
Practice Address - Street 1:3311 WASHINGTON RD
Practice Address - Street 2:STE 200
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-3114
Practice Address - Country:US
Practice Address - Phone:724-969-0930
Practice Address - Fax:724-969-0428
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-04
Last Update Date:2007-07-09
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Provider Licenses
StateLicense IDTaxonomies
PAMD-070131-L208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH16488Medicare UPIN