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Contact Information

SARA T GRANVILLE, PA
100 MAC LN
AVERA MEDICAL GROUP PIERRE
PIERRE, SD57501
 Phone: 605-945-5202
 Fax: 605-945-5094
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for SARA T GRANVILLE · (Female)

NPI # 1457670366
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 05/18/2010
Last updated 04/13/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • SD License # 745
Hospital affiliation(s)
  • ST MARY'S HOSPITAL - (Acute Care)
    801 E SIOUX
    PIERRE, SD 57501
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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