Provider Demographics
NPI:1417155441
Name:BEDARD, SARAH EMILY (PA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:EMILY
Last Name:BEDARD
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:EMILY
Other - Last Name:EMINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 5105
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-5100
Mailing Address - Country:US
Mailing Address - Phone:919-220-5255
Mailing Address - Fax:
Practice Address - Street 1:3714 GUARDIAN AVE
Practice Address - Street 2:SUITE E- CAROLINAS CENTER FOR SURGERY
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-2974
Practice Address - Country:US
Practice Address - Phone:252-247-2101
Practice Address - Fax:252-247-9469
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC001001181363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2759035Medicare PIN