Provider Demographics
NPI:1356342836
Name:WILHELM, SARA J (PA)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:J
Last Name:WILHELM
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:J
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 9202
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-9202
Mailing Address - Country:US
Mailing Address - Phone:610-376-8671
Mailing Address - Fax:610-376-6387
Practice Address - Street 1:301 S 7TH AVE
Practice Address - Street 2:STE 3220
Practice Address - City:WEST READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1410
Practice Address - Country:US
Practice Address - Phone:610-376-8671
Practice Address - Fax:610-376-6387
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA051483363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q00485Medicare UPIN
074433G7GMedicare ID - Type Unspecified