Provider Demographics
NPI:1053921650
Name:GOULD, SARAH (PA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:GOULD
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:2510 COMMONS BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-3821
Mailing Address - Country:US
Mailing Address - Phone:937-558-3062
Mailing Address - Fax:937-558-3067
Practice Address - Street 1:2510 COMMONS BLVD STE 210
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-3821
Practice Address - Country:US
Practice Address - Phone:937-429-0607
Practice Address - Fax:937-429-0608
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant