Provider Demographics
NPI:1649439522
Name:WEHMAN, MARIPAT G (PA-C)
Entity type:Individual
Prefix:
First Name:MARIPAT
Middle Name:G
Last Name:WEHMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:PATRICE
Other - Last Name:GRINAVICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2140 FISHER RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-5122
Mailing Address - Country:US
Mailing Address - Phone:717-766-1795
Mailing Address - Fax:717-697-6575
Practice Address - Street 1:49 PRINCE ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-3113
Practice Address - Country:US
Practice Address - Phone:717-901-3440
Practice Address - Fax:717-901-3447
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA000312L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant