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Individual

SARA B FERGUSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
32 COLONNADE WAY, STATE COLLEGE, PA 16803-2309
(814) 272-4445
(814) 272-4450
Mailing address
500 UNIVERSITY DR, HERSHEY, PA 17033-2360
(800) 243-1455

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD437015
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1023718890001
PA
01
129059
GEISINGER HEALTH PLAN
PA
01
163899KNC
MEDICARE PTAN
PA
01
FE2121236
HIGHMARK BLUE SHIELD
PA
Enumeration date
12/21/2005
Last updated
05/22/2014
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