Healthcare Provider Details

I. General information

NPI: 1770704439
Provider Name (Legal Business Name): SARA E WERTMAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 01/05/2022
Certification Date: 01/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E WENDOVER AVE STE 310
GREENSBORO NC
27401-1231
US

IV. Provider business mailing address

PO BOX 14878
GREENSBORO NC
27415
US

V. Phone/Fax

Practice location:
  • Phone: 336-832-3070
  • Fax:
Mailing address:
  • Phone: 336-832-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number102894
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: