MEDICARE: DANIELLE MARIE SAWREY-KUBICEK PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	0010-05205	NC

General Provider Information

NPI Number	:	1760885149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE MARIE SAWREY-KUBICEK PA

Provider Business Mailing Address
First Line	:	2920 HIGHWOODS BLVD
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27604-0010
Country	:	US
Telephone Number	:	877-498-4490
Fax Number	:

Provider Business Practice Location Address
First Line	:	7560 CARPENTER FIRE STATION RD STE 305
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27519-9637
Country	:	US
Telephone Number	:	919-235-6545
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2014
Last Update Date	:	04/13/2021

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