Provider Demographics
NPI:1730340274
Name:SAFFLE, SANDRA (PA-C)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:SAFFLE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2667
Mailing Address - Country:US
Mailing Address - Phone:740-283-7578
Mailing Address - Fax:740-283-7807
Practice Address - Street 1:1805 SINCLAIR AVE
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43953-3327
Practice Address - Country:US
Practice Address - Phone:740-346-2766
Practice Address - Fax:740-266-4981
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50 002100363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPA31431Medicare PIN