Provider Demographics
NPI:1598788838
Name:DEVITT, CHERYL ANN (PAC)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:ANN
Last Name:DEVITT
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:MISS
Other - First Name:CHERYL
Other - Middle Name:ANN
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PAC
Mailing Address - Street 1:5115 CENTRE AVE
Mailing Address - Street 2:FLOOR 3
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-1301
Mailing Address - Country:US
Mailing Address - Phone:412-235-1020
Mailing Address - Fax:412-235-1030
Practice Address - Street 1:5115 CENTRE AVE
Practice Address - Street 2:FLOOR 3
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1301
Practice Address - Country:US
Practice Address - Phone:412-235-1020
Practice Address - Fax:412-235-1030
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA003635L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q00074Medicare UPIN