Provider Demographics
NPI:1659301687
Name:IMERSHEIN, SARA L (MD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:L
Last Name:IMERSHEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3912 HARRISON ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-1938
Mailing Address - Country:US
Mailing Address - Phone:202-365-5300
Mailing Address - Fax:
Practice Address - Street 1:1225 4TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3431
Practice Address - Country:US
Practice Address - Phone:202-347-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD14394207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAQ263-0004OtherCAREFIRST BLUECROSS BLUESHIELD
DCC143-0002OtherBLUECHOICE BCBS
DCC88856Medicare UPIN