Provider Demographics
NPI:1801855887
Name:EWANSIK, STEVEN H (PA-C)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:H
Last Name:EWANSIK
Suffix:
Gender:M
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 1:9104 BABCOCK BLVD
Mailing Address - Street 2:SUITE 2120
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5818
Mailing Address - Country:US
Mailing Address - Phone:412-367-0600
Mailing Address - Fax:412-367-7079
Practice Address - Street 1:9104 BABCOCK BLVD
Practice Address - Street 2:SUITE 2120
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5818
Practice Address - Country:US
Practice Address - Phone:412-367-0600
Practice Address - Fax:412-367-7079
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA001315L363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA537098OtherHIGHMARK BLUE CROSS B.S.
PAR07425Medicare UPIN
PA044995EA0Medicare ID - Type Unspecified