Individual provider · Type 1 NPI
Ruby Pottukalam
Medical Physician Assistant · Meadowbrook, PA
NPI number
1417320920
Active
Practice location
1648 Huntingdon Pike
Meadowbrook, PA 19046-8001
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant | 363AM0700X | OA003584 (PA) |
| Medical Physician Assistant Primary | 363AM0700X | MA057714 (PA) |
Medical Physician Assistant: Definition to come...
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About NPI 1417320920
Ruby Pottukalam's National Provider Identifier is 1417320920, issued on Nov 5, 2015. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Meadowbrook, PA. The record was last updated on Sep 25, 2017.