Provider Demographics
NPI:1518360262
Name:HUTTON, EVAN JAMES (PA-C)
Entity Type:Individual
Prefix:MR
First Name:EVAN
Middle Name:JAMES
Last Name:HUTTON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 MOSSIDE BLVD STE 405
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3533
Mailing Address - Country:US
Mailing Address - Phone:412-373-1600
Mailing Address - Fax:
Practice Address - Street 1:2550 MOSSIDE BLVD STE 405
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3533
Practice Address - Country:US
Practice Address - Phone:412-373-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-08
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA063288363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant