Healthcare Provider Details

I. General information

NPI: 1649603531
Provider Name (Legal Business Name): SARAH MICHELLE GROSE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH MICHELLE REED PA-C

II. Dates (important events)

Enumeration Date: 08/14/2013
Last Update Date: 08/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 W LINCOLN HWY THE COMMONS AT OAKLANDS
EXTON PA
19341-2547
US

IV. Provider business mailing address

780 W LINCOLN HWY THE COMMONS AT OAKLANDS
EXTON PA
19341-2547
US

V. Phone/Fax

Practice location:
  • Phone: 610-873-1188
  • Fax: 610-873-1388
Mailing address:
  • Phone: 610-873-1188
  • Fax: 610-873-1388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: