MEDICARE: EMILY P HUNTER PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	MA057188	PA
2	363A00000X	Physician Assistant	OA003907	PA

General Provider Information

NPI Number	:	1467854794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY P HUNTER PA-C

Provider Business Mailing Address
First Line	:	2 W CRESCENT PARK
Second Line	:
City	:	WARREN
State	:	PA
Zip	:	16365-2111
Country	:	US
Telephone Number	:	814-723-2686
Fax Number	:	814-723-0425

Provider Business Practice Location Address
First Line	:	103 W SAINT CLAIR ST RM 2D
Second Line	:
City	:	WARREN
State	:	PA
Zip	:	16365-2188
Country	:	US
Telephone Number	:	814-723-2686
Fax Number	:	814-726-9417

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/18/2014
Last Update Date	:	08/12/2020

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