Provider Demographics
NPI:1043586225
Name:ALDRIDGE, SARAH ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:ALDRIDGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ELIZABETH
Other - Last Name:BLACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6100 LAKE FORREST DR
Mailing Address - Street 2:STE 100
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-3822
Mailing Address - Country:US
Mailing Address - Phone:404-252-4611
Mailing Address - Fax:
Practice Address - Street 1:6100 LAKE FORREST DR
Practice Address - Street 2:STE 100
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-3822
Practice Address - Country:US
Practice Address - Phone:404-252-4611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-01
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA73099208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA2199030Medicaid