Provider Demographics
NPI:1407836588
Name:UTHE, SARA LYNN (MD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:LYNN
Last Name:UTHE
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 1:1221 PLEASANT ST
Mailing Address - Street 2:SUITE 170
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1423
Mailing Address - Country:US
Mailing Address - Phone:515-241-4300
Mailing Address - Fax:515-241-4359
Practice Address - Street 1:1221 PLEASANT ST STE 170
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1424
Practice Address - Country:US
Practice Address - Phone:515-241-4300
Practice Address - Fax:515-241-4359
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA36162208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2485342Medicaid
IA1407836588Medicaid
I61435Medicare UPIN
IA1407836588Medicaid