Provider Demographics
NPI:1083706477
Name:SEABOLT, SARAH J (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:J
Last Name:SEABOLT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:J
Other - Last Name:YIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:277 OHUA AVE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-6612
Mailing Address - Country:US
Mailing Address - Phone:808-922-4787
Mailing Address - Fax:
Practice Address - Street 1:935 MAKAHIKI WAY
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-2896
Practice Address - Country:US
Practice Address - Phone:808-922-4787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-5557207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000027581OtherHMSA BILLING NUMBER
HI024749-02Medicaid
HI0000027581OtherHMSA BILLING NUMBER
HI0000BDNJBMedicare PIN