Provider Demographics
NPI:1760441554
Name:STAPLETON, SARAH (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:STAPLETON
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:PO BOX 751357
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1357
Mailing Address - Country:US
Mailing Address - Phone:843-792-6500
Mailing Address - Fax:843-792-6511
Practice Address - Street 1:30 BEE ST
Practice Address - Street 2:STE 2100
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-5847
Practice Address - Country:US
Practice Address - Phone:843-792-6500
Practice Address - Fax:843-792-6511
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC16509207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC165092Medicaid
SCF64521Medicare UPIN
SC165092Medicaid