Provider Demographics
NPI:1821482878
Name:MCAULIFF, SARAH L (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:L
Last Name:MCAULIFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:L
Other - Last Name:DAVIDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:121 MEDICAL VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:VT
Mailing Address - Zip Code:05855-9834
Mailing Address - Country:US
Mailing Address - Phone:802-334-5929
Mailing Address - Fax:
Practice Address - Street 1:121 MEDICAL VILLAGE DR
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:VT
Practice Address - Zip Code:05855-9834
Practice Address - Country:US
Practice Address - Phone:802-334-5929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-26
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.132338208000000X
VT042.0014294208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTY400593365OtherMEDICARE PTAN
OH0292584Medicaid
VT6700659Medicaid