Healthcare Provider Details

I. General information

NPI: 1225582323
Provider Name (Legal Business Name): MARKIAN ANDREW PAHUTA MD, PHD, FRCSC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2016
Last Update Date: 01/31/2021
Certification Date: 01/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 BARTON ST EAST
HAMILTON ON
L8L 2X2
CA

IV. Provider business mailing address

237 BARTON ST EAST
HAMILTON ON
L8L 2X2
CA

V. Phone/Fax

Practice location:
  • Phone: 905-521-2100
  • Fax: 905-527-6214
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number4301111030
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number4301111030
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: