MICAH LEE SERVIS SA-C NPI 1467752220

NPI Information

NPI: 1467752220
Provider Name: MICAH LEE SERVIS, SA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Address:
747 N RUTLEDGE ST
5TH FLOOR
SPRINGFIELD, IL
ZIP 62702
Phone: (217) 545-5878
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Micah Lee Servis, SA-C is a surgical physician assistant in Springfield, IL. Micah Lee Servis, SA-C NPI is 1467752220. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

747 N RUTLEDGE ST
5TH FLOOR
SPRINGFIELD, IL
ZIP 62702-700
Phone: (217) 545-5878
Fax: (217) 545-2586

The enumeration date for this NPI number is 10/27/2010 and was last updated on 10/27/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	238-000264	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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