Provider Demographics
NPI:1952596876
Name:KLUGH, ANDREW D (PA-C)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:D
Last Name:KLUGH
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 1:3120 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-4512
Mailing Address - Country:US
Mailing Address - Phone:724-342-2663
Mailing Address - Fax:724-342-8988
Practice Address - Street 1:3120 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-4512
Practice Address - Country:US
Practice Address - Phone:724-342-2663
Practice Address - Fax:724-342-8988
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA053135363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001997912OtherHIGHMARK BLUE SHIELD
PAMA053135OtherMEDICAL LICENSE
PAMA053135OtherMEDICAL LICENSE