Provider Demographics
NPI:1396264511
Name:BUCHHOLZ, JOSHUA (PA-C)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:BUCHHOLZ
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:JOSHUA
Other - Middle Name:J D
Other - Last Name:BUCHHOLZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:5230 CENTRE AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-1304
Mailing Address - Country:US
Mailing Address - Phone:412-864-7706
Mailing Address - Fax:
Practice Address - Street 1:647 N BROAD STREET EXT STE 107
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:PA
Practice Address - Zip Code:16127-4604
Practice Address - Country:US
Practice Address - Phone:724-458-8460
Practice Address - Fax:724-458-5062
Is Sole Proprietor?:No
Enumeration Date:2017-09-19
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1396264511363AM0700X
PAMA059275363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPENDINGMedicaid
PA14097826OtherCAQH