Provider Demographics
NPI:1346940327
Name:DERMES, SARAH SHAW (PA-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:SHAW
Last Name:DERMES
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 1:1315 HARDING PL APT 421
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-3545
Mailing Address - Country:US
Mailing Address - Phone:717-315-9087
Mailing Address - Fax:
Practice Address - Street 1:1315 HARDING PL APT 421
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-3545
Practice Address - Country:US
Practice Address - Phone:717-315-9087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-07
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant