Provider Demographics
NPI:1104135698
Name:MERTZ, SANDRA L (PA-C)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:L
Last Name:MERTZ
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2528 S ARLINGTON MILL DR APT E
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-4030
Mailing Address - Country:US
Mailing Address - Phone:703-379-8562
Mailing Address - Fax:703-379-2445
Practice Address - Street 1:2141 K ST NW STE 501
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1810
Practice Address - Country:US
Practice Address - Phone:202-994-6827
Practice Address - Fax:202-973-1572
Is Sole Proprietor?:No
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
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Provider Licenses
StateLicense IDTaxonomies
DCPA030648363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant