Provider Demographics
NPI:1750359824
Name:SARVIS, DEBORAH M (PA-C)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:M
Last Name:SARVIS
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 1:785 5TH AVENUE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-217-4217
Practice Address - Street 1:601 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:PA
Practice Address - Zip Code:17268-2332
Practice Address - Country:US
Practice Address - Phone:717-765-5088
Practice Address - Fax:717-765-5066
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA002626L363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103168009Medicaid
PA867633OtherMEDICARE GROUP #
PAMA002626LOtherLICENSE
PA25-1716306OtherHEALTHNET/TRICARE
PAP00456428OtherRAILROAD MEDICARE
PA50064073OtherCAPITAL BLUECROSS
PA652353OtherHEALTH AMERICA
PA25-1716306OtherINTERGROUP
PA25-1716306OtherDEVON
PA120420414OtherDEPT OF LLABOR
PA120420414OtherDEPT OF LLABOR
PA50064073OtherCAPITAL BLUECROSS
105267LN7Medicare PIN