Healthcare Provider Details

I. General information

NPI: 1013458587
Provider Name (Legal Business Name): SARAH WEYMOUTH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH BIANCHI PA-C

II. Dates (important events)

Enumeration Date: 03/16/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66440 GRATIOT AVE
LENOX MI
48050
US

IV. Provider business mailing address

PO BOX 187
RICHMOND MI
48062
US

V. Phone/Fax

Practice location:
  • Phone: 586-727-5840
  • Fax: 586-727-5897
Mailing address:
  • Phone: 586-727-5840
  • Fax: 586-727-5897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number5601008135
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: