Provider Demographics
NPI:1164718946
Name:MORGAN, SAMANTHA R (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:R
Last Name:MORGAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:SAMANTHA
Other - Middle Name:A
Other - Last Name:RICHARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:98 WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-3335
Mailing Address - Country:US
Mailing Address - Phone:724-229-1756
Mailing Address - Fax:724-229-2429
Practice Address - Street 1:1001 WATERDAM PLAZA DR
Practice Address - Street 2:
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-2466
Practice Address - Country:US
Practice Address - Phone:724-969-1001
Practice Address - Fax:724-260-5448
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV540363A00000X
PAMA055399363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant