Individual
CARLIE POPOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1307 FEDERAL ST STE 2, PITTSBURGH, PA 15212-4769
(877) 660-6777
(412) 359-8055
Mailing address
1307 FEDERAL ST STE 2, PITTSBURGH, PA 15212-4769
(877) 660-6777
(412) 359-8055
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA059325
PA
363AS0400X
Surgical Physician Assistant
Primary
MA059325
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103394340
—
PA
01
—
14123570
CAQH
—
Enumeration date
10/10/2017
Last updated
10/12/2020
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