Provider Demographics
NPI:1891976866
Name:WALSH, SARAH NOEL (MD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:NOEL
Last Name:WALSH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:N
Other - Last Name:WALSH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2326 MILLPARK DR
Mailing Address - Street 2:
Mailing Address - City:MARYLAND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63043-3530
Mailing Address - Country:US
Mailing Address - Phone:314-991-4313
Mailing Address - Fax:314-991-4317
Practice Address - Street 1:2326 MILLPARK DR
Practice Address - Street 2:
Practice Address - City:MARYLAND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63043-3530
Practice Address - Country:US
Practice Address - Phone:314-991-4313
Practice Address - Fax:314-991-4317
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-19
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007006901207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology