Doctor Name: | SARAH NELL SHOMPER |
NPI Number: | 1013321462 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | |
Business Practice Address: | 20010 Century Blvd Ste 200 Germantown, MD - 208741118 |
Business Phone Number: | 2406862300 |
Business Fax Number: | |
Mailing Address: | 22235 Timberline Ct, LEONARDTOWN |
State: | MD |
Postal Code: | 206505610 |
Phone Number: | 2405381376 |
Fax Number: | |
NPI Enumeration Date: | 06/13/2014 |
NPI Last Update Date: | 12/22/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |