Provider Demographics
NPI:1356576987
Name:DEBONE, SAMANTHA (PA-C)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:DEBONE
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 1:222 E MCMURRAY RD
Mailing Address - Street 2:
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-2948
Mailing Address - Country:US
Mailing Address - Phone:724-969-2500
Mailing Address - Fax:724-426-7718
Practice Address - Street 1:222 E MCMURRAY RD
Practice Address - Street 2:
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-2948
Practice Address - Country:US
Practice Address - Phone:724-969-2500
Practice Address - Fax:724-426-7718
Is Sole Proprietor?:No
Enumeration Date:2009-05-27
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA003095363A00000X
PAMA056267363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant