Provider Demographics
NPI:1760511646
Name:SAUCIER, NATHAN ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:ANTHONY
Last Name:SAUCIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 PALADIN DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-7826
Mailing Address - Country:US
Mailing Address - Phone:252-752-8880
Mailing Address - Fax:252-317-3092
Practice Address - Street 1:970 NEWMAN RD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-5200
Practice Address - Country:US
Practice Address - Phone:252-633-9262
Practice Address - Fax:252-317-2094
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN50134207RN0300X
NC2005-01698207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN281622000Medicaid
MNP00468510OtherRAILROAD MEDICARE
MN281622000Medicaid