Provider Demographics
NPI:1528591682
Name:PENQUITE, SARA ASHLYN (MD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:ASHLYN
Last Name:PENQUITE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1656 E MABEL ST 4TH FLOOR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85721-5241
Mailing Address - Country:US
Mailing Address - Phone:520-626-6376
Mailing Address - Fax:520-621-2919
Practice Address - Street 1:3838 N CAMPBELL AVE BLDG 2
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-1454
Practice Address - Country:US
Practice Address - Phone:520-694-8888
Practice Address - Fax:520-874-2251
Is Sole Proprietor?:No
Enumeration Date:2017-04-06
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZR77937207RE0101X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ66148OtherARIZONA STATE LICENSE