Provider Demographics
NPI:1659701167
Name:MCCULLOUGH, EMILY HELENE (PA-C)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:HELENE
Last Name:MCCULLOUGH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 SUMNER ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-2600
Mailing Address - Country:US
Mailing Address - Phone:412-298-2970
Mailing Address - Fax:
Practice Address - Street 1:2 HOT METAL ST
Practice Address - Street 2:QUANTAM ONE 2 FL
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-2348
Practice Address - Country:US
Practice Address - Phone:412-432-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-19
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA056603363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical