Provider Demographics
NPI:1871543058
Name:DEWITT, SARAH ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ELIZABETH
Last Name:DEWITT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N PERSON ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-1214
Mailing Address - Country:US
Mailing Address - Phone:919-838-5254
Mailing Address - Fax:919-838-5201
Practice Address - Street 1:600 N PERSON ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-1214
Practice Address - Country:US
Practice Address - Phone:919-838-5254
Practice Address - Fax:919-838-5201
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89127E0Medicaid
NCG99839Medicare UPIN
NC2280607EMedicare ID - Type Unspecified
NC89127E0Medicaid