Provider Demographics
NPI:1497276489
Name:WONDISFORD, SARAH RADOVICK (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:RADOVICK
Last Name:WONDISFORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1350 LOCUST ST STE 105
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-4738
Mailing Address - Country:US
Mailing Address - Phone:412-232-8840
Mailing Address - Fax:412-232-3690
Practice Address - Street 1:1350 LOCUST ST STE 105
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-4738
Practice Address - Country:US
Practice Address - Phone:412-232-8840
Practice Address - Fax:412-232-3690
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD4754212084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology