Provider Demographics
NPI:1376653576
Name:DUMOND, SARA OYLER (MD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:OYLER
Last Name:DUMOND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6401 STARGAZE LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-0802
Mailing Address - Country:US
Mailing Address - Phone:704-560-4169
Mailing Address - Fax:704-464-1818
Practice Address - Street 1:6401 STARGAZE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-0802
Practice Address - Country:US
Practice Address - Phone:704-560-4169
Practice Address - Fax:704-464-1818
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200200214208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89135HHMedicaid
NCH98566Medicare UPIN