Provider Demographics
NPI:1821031998
Name:SAURMAN, DAVID A (PA-C)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:A
Last Name:SAURMAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 EAST HOWARD AVENUE
Mailing Address - Street 2:TETON VALLEY HEALTH CARE
Mailing Address - City:DRIGGS
Mailing Address - State:ID
Mailing Address - Zip Code:83422-5112
Mailing Address - Country:US
Mailing Address - Phone:208-354-6302
Mailing Address - Fax:208-354-3158
Practice Address - Street 1:120 EAST HOWARD AVENUE
Practice Address - Street 2:TETON VALLEY HEALTH CARE
Practice Address - City:DRIGGS
Practice Address - State:ID
Practice Address - Zip Code:83422-5112
Practice Address - Country:US
Practice Address - Phone:208-354-6302
Practice Address - Fax:208-354-3158
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY238363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY1192477Medicaid
WY1192477Medicaid
WYP06962Medicare UPIN