Provider Demographics
NPI:1750763413
Name:BLOCHBERGER, MUIR (PA-C)
Entity type:Individual
Prefix:
First Name:MUIR
Middle Name:
Last Name:BLOCHBERGER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MUIR
Other - Middle Name:
Other - Last Name:KEPLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:100 HOSPITAL AVE
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-1440
Mailing Address - Country:US
Mailing Address - Phone:814-375-3800
Mailing Address - Fax:814-375-3886
Practice Address - Street 1:100 HOSPITAL AVE
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-1440
Practice Address - Country:US
Practice Address - Phone:814-375-3800
Practice Address - Fax:814-375-3886
Is Sole Proprietor?:No
Enumeration Date:2015-06-18
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA363A00000X
PAMA057640363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant