Provider Demographics
NPI:1386852101
Name:REGAN, SARAH L (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:L
Last Name:REGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:L
Other - Last Name:CARRICABURU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:224D CORNWALL ST NW STE 403
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-2704
Mailing Address - Country:US
Mailing Address - Phone:703-737-6001
Mailing Address - Fax:703-443-8643
Practice Address - Street 1:205 E. HIRST ROAD, SUITE 303
Practice Address - Street 2:
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132-6602
Practice Address - Country:US
Practice Address - Phone:540-338-9896
Practice Address - Fax:540-338-8235
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101241656207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA30015930110001Medicaid
VA1386852101Medicaid