MEDICARE: SANDRA BAIER MCCARTHY PA-C

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	2116	AZ
2	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	9293	MN

General Provider Information

NPI Number	:	1134196348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA BAIER MCCARTHY PA-C

Provider Business Mailing Address
First Line	:	425 ELM ST N
Second Line	:
City	:	SAUK CENTRE
State	:	MN
Zip	:	56378-1010
Country	:	US
Telephone Number	:	320-352-2221
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 ELM ST N
Second Line	:
City	:	SAUK CENTRE
State	:	MN
Zip	:	56378-1010
Country	:	US
Telephone Number	:	855-295-0058
Fax Number	:

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

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	12/04/2021

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