Provider Demographics
NPI:1558535989
Name:GRAVES, SARA CATHERINE (MD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:CATHERINE
Last Name:GRAVES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:CATHERINE
Other - Last Name:LEWICKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 547
Mailing Address - Street 2:ATT: CVMC FINANCE DEPT
Mailing Address - City:BARRE
Mailing Address - State:VT
Mailing Address - Zip Code:05641-0547
Mailing Address - Country:US
Mailing Address - Phone:802-225-3970
Mailing Address - Fax:802-225-1733
Practice Address - Street 1:130 FISHER RD, MOB-B, STE 4
Practice Address - Street 2:CVMC ORTHOPEDICS & SPORTS MEDICINE
Practice Address - City:BERLIN
Practice Address - State:VT
Practice Address - Zip Code:05602-9516
Practice Address - Country:US
Practice Address - Phone:802-225-3970
Practice Address - Fax:802-225-1733
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH15982207X00000X
MN58038207X00000X
VT042.0013090207X00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1024963Medicaid
VTY400238384Medicare PIN