Provider Demographics
NPI:1295813319
Name:JAMIESON, SARAH ELIZABETH (PA-C)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:JAMIESON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ELIZABETH
Other - Last Name:FIKE LAYMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:172 THOMAS JOHNSON DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702
Mailing Address - Country:US
Mailing Address - Phone:301-694-0900
Mailing Address - Fax:301-694-0657
Practice Address - Street 1:172 THOMAS JOHNSON DR
Practice Address - Street 2:SUITE 100
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702
Practice Address - Country:US
Practice Address - Phone:301-694-0900
Practice Address - Fax:301-694-0657
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0002816363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q18068Medicare UPIN
MD424MN717Medicare ID - Type Unspecified