Provider Demographics
NPI:1558476754
Name:SIMONA V. PAUTLER,M.D.,P.C.
Entity Type:Organization
Organization Name:SIMONA V. PAUTLER,M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SIMONA
Authorized Official - Middle Name:V
Authorized Official - Last Name:PAUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-969-0930
Mailing Address - Street 1:3311 WASHINGTON RD STE 200
Mailing Address - Street 2:
Mailing Address - City:MCMURRAY
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 STE 200
Practice Address - Street 2:
Practice Address - City:MCMURRAY
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD070131L208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH16488Medicare UPIN
PA038151Medicare ID - Type UnspecifiedMEDICARE