Basic Information
| Provider Information | |||||||||
| NPI: | 1750359824 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SARVIS | ||||||||
| FirstName: | DEBORAH | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 785 5TH AVENUE | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172014232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172639555 | ||||||||
| FaxNumber: | 7172174217 | ||||||||
| Practice Location | |||||||||
| Address1: | 601 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | WAYNESBORO | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172682332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177655088 | ||||||||
| FaxNumber: | 7177655066 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2006 | ||||||||
| LastUpdateDate: | 08/18/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | MA002626L | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
ID Information
| ID | Type | State | Issuer | Description | 103168009 | 05 | PA | MEDICAID | 867633 | 01 | PA | MEDICARE GROUP # | OTHER | MA002626L | 01 | PA | LICENSE | OTHER | 25-1716306 | 01 | PA | HEALTHNET/TRICARE | OTHER | P00456428 | 01 | PA | RAILROAD MEDICARE | OTHER | 50064073 | 01 | PA | CAPITAL BLUECROSS | OTHER | 652353 | 01 | PA | HEALTH AMERICA | OTHER | MS0367311 | 01 | PA | DEA | OTHER | 25-1716306 | 01 | PA | INTERGROUP | OTHER | 25-1716306 | 01 | PA | DEVON | OTHER | 120420414 | 01 | PA | DEPT OF LLABOR | OTHER |