Provider Demographics
NPI:1699822585
Name:NORVELL, SARA M (MD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:M
Last Name:NORVELL
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 1:5811 STERLING DR
Mailing Address - Street 2:APT. 9
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-4432
Mailing Address - Country:US
Mailing Address - Phone:615-618-9573
Mailing Address - Fax:
Practice Address - Street 1:5811 STERLING DR
Practice Address - Street 2:APT. 9
Practice Address - City:GRANGER
Practice Address - State:IN
Practice Address - Zip Code:46530-4432
Practice Address - Country:US
Practice Address - Phone:615-618-9573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01065699A207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200928990Medicaid
IN169130CCMedicare PIN