Provider Demographics
NPI:1366413890
Name:MILLER, SARAH B (PA-C)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:B
Last Name:MILLER
Suffix:
Gender:F
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 1:2400 CORPORATE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-7645
Mailing Address - Country:US
Mailing Address - Phone:724-935-4700
Mailing Address - Fax:
Practice Address - Street 1:2400 CORPORATE DR STE 100
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-7645
Practice Address - Country:US
Practice Address - Phone:724-935-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA051211363A00000X
PAOA006367363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA074351Medicare ID - Type Unspecified
PAQ00377Medicare UPIN