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General NPI Number Information
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NPI Number | 1386879567
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Entity Type | Organization
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Legal Business Name | WEXFORD ANESTHESIA ASSOCIATES, PC
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Dates
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Enumeration Date | 05/18/2009
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Last Update Date | 05/18/2009
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Provider Practice Location Address
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Address Line | 6001 STONEWOOD DR
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City | WEXFORD
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State | PA
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Zip | 15090-7380
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Country | US
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Telephone | 724-933-3810
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Fax |
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Provider Business Mailing Address
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Address Line | 6001 STONEWOOD DR
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City | WEXFORD
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State | PA
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Zip | 15090-7380
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Country | US
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Telephone | 724-933-3810
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GLEN BUTERBAUGH
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Credential | M.D.
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Telephone | 724-933-3810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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