Provider Demographics
NPI:1326205006
Name:GREKIN, SARAH (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:GREKIN
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 1:1380 LUSITANA ST STE 412
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2440
Mailing Address - Country:US
Mailing Address - Phone:808-599-3780
Mailing Address - Fax:808-538-1672
Practice Address - Street 1:1380 LUSITANA ST STE 412
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2440
Practice Address - Country:US
Practice Address - Phone:808-599-3780
Practice Address - Fax:808-538-1672
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN9214207N00000X
MI4301091633390200000X
HI18431207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8DL764OtherBCBS (MDACC)
TX304471101 (MDACC)Medicaid
MI4301091633OtherLTD EDUC LICENSE
TXTXB159644 (MDACC)Medicare PIN