Provider Demographics
NPI:1336444819
Name:FICKNER, STEVEN (PA-C)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:FICKNER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 QUINN DR STE 160
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15275-1055
Mailing Address - Country:US
Mailing Address - Phone:412-722-1003
Mailing Address - Fax:412-722-1385
Practice Address - Street 1:200 QUINN DR STE 160
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15275-1055
Practice Address - Country:US
Practice Address - Phone:412-722-1003
Practice Address - Fax:412-722-1385
Is Sole Proprietor?:No
Enumeration Date:2011-01-14
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA054738363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103267811Medicaid
PA103267811Medicaid