Provider Demographics
NPI:1013458587
Name:WEYMOUTH, SARAH (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:WEYMOUTH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:BIANCHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 187
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:MI
Mailing Address - Zip Code:48062
Mailing Address - Country:US
Mailing Address - Phone:586-727-5840
Mailing Address - Fax:586-727-5897
Practice Address - Street 1:66440 GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:LENOX
Practice Address - State:MI
Practice Address - Zip Code:48050
Practice Address - Country:US
Practice Address - Phone:586-727-5840
Practice Address - Fax:586-727-5897
Is Sole Proprietor?:No
Enumeration Date:2017-03-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601008135363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical