Healthcare Provider Details

I. General information

NPI: 1386879567
Provider Name (Legal Business Name): WEXFORD ANESTHESIA ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2009
Last Update Date: 05/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 STONEWOOD DR
WEXFORD PA
15090-7380
US

IV. Provider business mailing address

6001 STONEWOOD DR
WEXFORD PA
15090-7380
US

V. Phone/Fax

Practice location:
  • Phone: 724-933-3810
  • Fax:
Mailing address:
  • Phone: 724-933-3810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: DR. GLEN BUTERBAUGH
Title or Position: PRESIDENT
Credential: M.D.
Phone: 724-933-3810