Provider Demographics
NPI:1578058988
Name:CARBAUGH, BETHANY AMARIS (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:AMARIS
Last Name:CARBAUGH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:AMARIS
Other - Last Name:MAGNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:301-797-9240
Mailing Address - Fax:301-797-4234
Practice Address - Street 1:17 WESTERN MARYLAND PKWY STE 100
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5471
Practice Address - Country:US
Practice Address - Phone:301-797-9240
Practice Address - Fax:301-797-4234
Is Sole Proprietor?:No
Enumeration Date:2018-06-27
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA062413363A00000X
MDC06855363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant