Provider Demographics
NPI:1164644381
Name:LINDSAY, SARA MCCLEAVE (MD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:MCCLEAVE
Last Name:LINDSAY
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 1:509 POINSETTIA DRIVE
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-3438
Mailing Address - Country:US
Mailing Address - Phone:864-967-2673
Mailing Address - Fax:
Practice Address - Street 1:509 POINSETTIA DRIVE
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-3438
Practice Address - Country:US
Practice Address - Phone:864-967-2673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10352207Q00000X
NC9601377207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC103523Medicaid
D18180Medicare UPIN