Provider Demographics
NPI:1528392818
Name:CVETICH, AMBER L (MPAS)
Entity Type:Individual
Prefix:MISS
First Name:AMBER
Middle Name:L
Last Name:CVETICH
Suffix:
Gender:F
Credentials:MPAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 S AIKEN AVE
Mailing Address - Street 2:SHADYSIDE PLACE, SUITE 500
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-1531
Mailing Address - Country:US
Mailing Address - Phone:412-688-3653
Mailing Address - Fax:412-687-4654
Practice Address - Street 1:580 S AIKEN AVE
Practice Address - Street 2:SHADYSIDE PLACE, SUITE 500
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1531
Practice Address - Country:US
Practice Address - Phone:412-688-3653
Practice Address - Fax:412-687-4654
Is Sole Proprietor?:No
Enumeration Date:2009-09-20
Last Update Date:2009-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATMA052155363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant