Provider Demographics
NPI:1093700056
Name:BREEDEN, SARA M (MD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:M
Last Name:BREEDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:6439 IRON BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23234-5205
Mailing Address - Country:US
Mailing Address - Phone:804-271-8990
Mailing Address - Fax:804-271-9020
Practice Address - Street 1:6439 IRON BRIDGE RD
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23234-5205
Practice Address - Country:US
Practice Address - Phone:804-271-8990
Practice Address - Fax:804-271-9020
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2022-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101058068207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5633079Medicaid
VAG31205Medicare UPIN
VA5633079Medicaid