Provider Demographics
NPI:1821278409
Name:EDWARDS, SARAH MARIE (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:EDWARDS
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 1:4725 PIEDMONT ROW DR STE 130
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-4276
Mailing Address - Country:US
Mailing Address - Phone:423-914-0863
Mailing Address - Fax:
Practice Address - Street 1:4725 PIEDMONT ROW DR STE 130
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-4276
Practice Address - Country:US
Practice Address - Phone:423-914-0863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2008-01698207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5913681Medicaid
NC2073803Medicare PIN