Provider Demographics
NPI:1457376600
Name:ANDREWS, DIANA D (PA-C)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:D
Last Name:ANDREWS
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 1:1350 LOCUST ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-4738
Mailing Address - Country:US
Mailing Address - Phone:412-562-3292
Mailing Address - Fax:412-281-2610
Practice Address - Street 1:1350 LOCUST ST
Practice Address - Street 2:SUITE 100
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-4738
Practice Address - Country:US
Practice Address - Phone:412-562-3292
Practice Address - Fax:412-281-2610
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA000550L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA077279GK7Medicare ID - Type Unspecified
Q10720Medicare UPIN