Provider Demographics
NPI:1578522637
Name:MORELAND, SARA A (CRNA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:A
Last Name:MORELAND
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 711841
Mailing Address - Street 2:MID ATLANTIC ANESTHESIA CONSULTANTS PLLC
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43271-0001
Mailing Address - Country:US
Mailing Address - Phone:304-346-9400
Mailing Address - Fax:304-234-5732
Practice Address - Street 1:1200 J D ANDERSON DR
Practice Address - Street 2:MONONGALIA GENERAL HOSPITAL
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-3494
Practice Address - Country:US
Practice Address - Phone:304-346-9400
Practice Address - Fax:304-345-7320
Is Sole Proprietor?:No
Enumeration Date:2006-03-18
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV23625367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0207026000Medicaid
WV27005299701OtherWORKERS COMP GROUP
WVDA0096OtherRR MEDICARE
WV1056021OtherWORKERSCOMP-MAAC
WVP00288019OtherRR MEDICARE
WV2603006000Medicaid
WV270052997004OtherTRICARE
WV270052997004OtherTRICARE
WV9333201Medicare PIN
WVP00288019OtherRR MEDICARE