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General NPI Number Information
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NPI Number | 1447220082
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Entity Type | Organization
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Legal Business Name | WESTERN PA SURGERY CENTER, WEXFORD BRANCH, LLC
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 05/10/2023
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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 | 724-933-3800
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Fax | 724-933-3801
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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 | 724-933-3800
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Fax | 724-933-3801
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. GLENN A BUTERBAUGH
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Credential | MD
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Telephone | 724-933-3800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 20221501
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License Number State | PA
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