Provider Demographics
NPI:1609586502
Name:SPARROW FAMILY MEDICINE, PLLC
Entity Type:Organization
Organization Name:SPARROW FAMILY MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:CAVICCHIA MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-306-8339
Mailing Address - Street 1:240 N 7TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:PA
Mailing Address - Zip Code:17501-1366
Mailing Address - Country:US
Mailing Address - Phone:717-478-3850
Mailing Address - Fax:717-402-9113
Practice Address - Street 1:240 N 7TH ST STE 500
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:PA
Practice Address - Zip Code:17501-1366
Practice Address - Country:US
Practice Address - Phone:717-478-3850
Practice Address - Fax:717-402-9113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty