Provider Demographics
NPI:1013228238
Name:BROOKS, SARAH ASHLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ASHLEY
Last Name:BROOKS
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 1:169 ASHLEY AVE RM 202
Mailing Address - Street 2:MSC333
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29425-7316
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3300 BUCKEYE RD
Practice Address - Street 2:SUITE 178
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341-4229
Practice Address - Country:US
Practice Address - Phone:770-458-6103
Practice Address - Fax:770-234-0437
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL32893207ZP0102X
GA75947207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003181400AMedicaid
GA003181400AMedicaid