Provider Demographics
NPI:1619196557
Name:WEST, SARAH KLIZAS (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:KLIZAS
Last Name:WEST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ANN
Other - Last Name:KLIZAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2215 LANDOVER PL
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-2115
Mailing Address - Country:US
Mailing Address - Phone:434-947-3944
Mailing Address - Fax:866-617-8273
Practice Address - Street 1:2215 LANDOVER PL
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-2115
Practice Address - Country:US
Practice Address - Phone:434-947-3944
Practice Address - Fax:866-617-8273
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD26608390200000X
VA0101255311207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1619196557Medicaid
VAVVC660A933Medicare PIN
VAVVC660AMedicare PIN