Provider Demographics
NPI:1235136433
Name:GERMANSON, SARAH W (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:W
Last Name:GERMANSON
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 1:364 HONEYSUCKLE RD
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36305-1140
Mailing Address - Country:US
Mailing Address - Phone:334-794-8656
Mailing Address - Fax:877-389-4229
Practice Address - Street 1:364 HONEYSUCKLE RD
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-1140
Practice Address - Country:US
Practice Address - Phone:334-794-8656
Practice Address - Fax:877-389-4229
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL24270208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009917275Medicaid
AL630738893OtherTAX ID
GA392822822AMedicaid
AL009917275Medicaid