Provider Demographics
NPI:1639573652
Name:BUCHER, PAMELA ROSE (PA)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:ROSE
Last Name:BUCHER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5820 CENTRE AVENUE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-3710
Mailing Address - Country:US
Mailing Address - Phone:412-661-5500
Mailing Address - Fax:412-661-4365
Practice Address - Street 1:5820 CENTRE AVENUE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-3710
Practice Address - Country:US
Practice Address - Phone:412-661-5500
Practice Address - Fax:412-661-4365
Is Sole Proprietor?:No
Enumeration Date:2014-10-20
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.004145363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMA058222OtherMEDICAL LICENSE
OH0115221Medicaid