Provider Demographics
NPI:1861442915
Name:POWELL, SARAH P (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:P
Last Name:POWELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:LYNN
Other - Last Name:PERTZBORN POWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:26 SPANISH BAY
Mailing Address - Street 2:
Mailing Address - City:DAKOTA DUNES
Mailing Address - State:SD
Mailing Address - Zip Code:57049-5447
Mailing Address - Country:US
Mailing Address - Phone:712-389-4155
Mailing Address - Fax:605-217-2948
Practice Address - Street 1:101 TOWER RD
Practice Address - Street 2:SUITE 120
Practice Address - City:DAKOTA DUNES
Practice Address - State:SD
Practice Address - Zip Code:57049-5007
Practice Address - Country:US
Practice Address - Phone:605-217-4320
Practice Address - Fax:605-217-2948
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA36300207Y00000X
FLME86858207Y00000X
SD6016207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1470492Medicaid
NE42101987207Medicaid
IA00642OtherBCBS PROVIDER NUMBER
IA0470492Medicaid
NE10025206800Medicaid
IA0470492Medicaid
IAI16197Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
IAI16104Medicare ID - Type Unspecified2ND MEDICARE PROVIDER NUM