Provider Demographics
NPI:1518205913
Name:FENTON, SARA JAYE
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:JAYE
Last Name:FENTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 WEST ST UNIT 107
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3763
Mailing Address - Country:US
Mailing Address - Phone:410-224-2328
Mailing Address - Fax:
Practice Address - Street 1:1730 WEST ST UNIT 107
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3763
Practice Address - Country:US
Practice Address - Phone:410-224-2328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-21
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist