Provider Demographics
NPI:1528019528
Name:OLENICK, SARAH J (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:J
Last Name:OLENICK
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 CLUBSIDE DR
Mailing Address - Street 2:
Mailing Address - City:STONEY CREEK
Mailing Address - State:NC
Mailing Address - Zip Code:27377-9227
Mailing Address - Country:US
Mailing Address - Phone:336-446-8251
Mailing Address - Fax:336-446-8240
Practice Address - Street 1:1447 YORK CT
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-3361
Practice Address - Country:US
Practice Address - Phone:336-436-3725
Practice Address - Fax:336-436-0629
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9400315207ZC0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Not Answered207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F83630Medicare UPIN