Provider Demographics
NPI:1093706400
Name:AXEL, SARAH M (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:M
Last Name:AXEL
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 1:46 SCITUATE AVE
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:MA
Mailing Address - Zip Code:02066-3524
Mailing Address - Country:US
Mailing Address - Phone:617-653-7281
Mailing Address - Fax:
Practice Address - Street 1:46 SCITUATE AVE
Practice Address - Street 2:
Practice Address - City:SCITUATE
Practice Address - State:MA
Practice Address - Zip Code:02066-3524
Practice Address - Country:US
Practice Address - Phone:617-653-7281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-03
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA58100208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAXJ07253OtherBCBS
457040OtherTUFTS USFHP
1200503OtherUNITED
0 058100OtherTUFTS
MA200465OtherHPHC
MA3032159Medicaid
355281OtherCIGNA
MAJ07253Medicare ID - Type Unspecified
1200503OtherUNITED