Provider Demographics
NPI:1700990082
Name:MUNCH, SARAH MARIE (PA-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:MUNCH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:MARIE
Other - Last Name:JOSLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2350 E G AVE
Mailing Address - Street 2:
Mailing Address - City:PARCHMENT
Mailing Address - State:MI
Mailing Address - Zip Code:49004-1943
Mailing Address - Country:US
Mailing Address - Phone:269-344-6183
Mailing Address - Fax:269-349-3046
Practice Address - Street 1:2350 E G AVE
Practice Address - Street 2:
Practice Address - City:PARCHMENT
Practice Address - State:MI
Practice Address - Zip Code:49004-1943
Practice Address - Country:US
Practice Address - Phone:269-344-6183
Practice Address - Fax:269-349-3046
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601003751363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P38930003Medicare PIN
0P38930Medicare ID - Type UnspecifiedMEDICARE GROUP
Q73781Medicare UPIN