Provider Demographics
NPI:1760472435
Name:BUCHERT, SARAH LYNN (PAC)
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:LYNN
Last Name:BUCHERT
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3249 GLENMORE AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-6637
Mailing Address - Country:US
Mailing Address - Phone:513-354-3700
Mailing Address - Fax:513-662-1854
Practice Address - Street 1:3249 GLENMORE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-6637
Practice Address - Country:US
Practice Address - Phone:513-354-3700
Practice Address - Fax:513-662-1854
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50-00-1993363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000313328OtherANTHEM
OHPA993SOtherHUMANA
OHBUPA21231Medicare ID - Type Unspecified