Provider Demographics
NPI:1679007389
Name:PUIM, SARAH JEAN (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JEAN
Last Name:PUIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:5625 PINCKNEY AVE
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29577-2225
Mailing Address - Country:US
Mailing Address - Phone:843-999-1292
Mailing Address - Fax:281-595-1318
Practice Address - Street 1:809 82ND PARKWAY
Practice Address - Street 2:GRAND STRAND MEDICAL CENTER
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572
Practice Address - Country:US
Practice Address - Phone:843-236-1950
Practice Address - Fax:843-692-1122
Is Sole Proprietor?:No
Enumeration Date:2017-04-19
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
SC51345207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program