Provider Demographics
NPI:1730499070
Name:MOHR, SARAH LOUISE (PA-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LOUISE
Last Name:MOHR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:LOUISE
Other - Last Name:BOWMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:602 S. ATWOOD RD
Mailing Address - Street 2:#200 A
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4396
Mailing Address - Country:US
Mailing Address - Phone:410-515-6774
Mailing Address - Fax:410-515-0356
Practice Address - Street 1:602 S. ATWOOD RD
Practice Address - Street 2:#200 A
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4396
Practice Address - Country:US
Practice Address - Phone:410-515-6774
Practice Address - Fax:410-515-0356
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0004369363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD197496Y1PMedicare PIN