Healthcare Provider Details

I. General information

NPI: 1093147498
Provider Name (Legal Business Name): SARAH MORRISON GUTHRIE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2013
Last Update Date: 03/25/2024
Certification Date: 03/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 MAPLE AVE W
VIENNA VA
22180-5727
US

IV. Provider business mailing address

2435 W BELVEDERE AVE STE 32
BALTIMORE MD
21215-5224
US

V. Phone/Fax

Practice location:
  • Phone: 571-363-3539
  • Fax:
Mailing address:
  • Phone: 410-601-0900
  • Fax: 410-601-0901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110008758
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number6859
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC06780
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: