Provider Demographics
NPI:1194824110
Name:WIERZBICKI, SARA ANNE (PA C)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ANNE
Last Name:WIERZBICKI
Suffix:
Gender:F
Credentials:PA C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3100 CROSS CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-2774
Mailing Address - Country:US
Mailing Address - Phone:248-377-8000
Mailing Address - Fax:
Practice Address - Street 1:3100 CROSS CREEK PKWY
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-2774
Practice Address - Country:US
Practice Address - Phone:248-377-8000
Practice Address - Fax:248-377-2929
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5601004904363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant