MEDICARE: MRS. SARAH MARIE CALVEY 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	363AM0700X	Medical Physician Assistant	PA9103558	FL
2	363AS0400X	Surgical Physician Assistant	PA9103558	FL
3	363A00000X	Physician Assistant	PA9103558	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	K0493	OTHER		GROUP MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	002876700	OTHER	FL	GROUP MEDICIAD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336164698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SARAH MARIE CALVEY PA-C

Provider Business Mailing Address
First Line	:	PO BOX 935921
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	31193-5921
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	21 HOSPITAL DR STE 110
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32164-2453
Country	:	US
Telephone Number	:	386-586-1910
Fax Number	:	386-583-1912

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

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	12/02/2024

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Directions to “ MRS. SARAH MARIE CALVEY PA-C” Practice Location

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