Provider Demographics
NPI:1730474016
Name:CAMARATA, SARA LYNN (DO)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:LYNN
Last Name:CAMARATA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:LYNN
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1205 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:SC
Mailing Address - Zip Code:29571-2008
Mailing Address - Country:US
Mailing Address - Phone:843-423-0760
Mailing Address - Fax:843-423-8136
Practice Address - Street 1:1205 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:SC
Practice Address - Zip Code:29571
Practice Address - Country:US
Practice Address - Phone:843-423-0760
Practice Address - Fax:843-423-8136
Is Sole Proprietor?:No
Enumeration Date:2011-06-14
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101019304207Q00000X
SC37593207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine