Provider Demographics
NPI:1346279338
Name:MOSTAD, SARA B (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:B
Last Name:MOSTAD
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:410 BIRCHWOOD AVE 201
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1783
Mailing Address - Country:US
Mailing Address - Phone:360-733-0116
Mailing Address - Fax:360-733-0119
Practice Address - Street 1:410 BIRCHWOOD AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1783
Practice Address - Country:US
Practice Address - Phone:360-752-9919
Practice Address - Fax:360-752-1647
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00041439207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAH82972Medicare UPIN