Provider Demographics
NPI:1942302807
Name:KELISCHEK, SABINE ARWEN (MD)
Entity Type:Individual
Prefix:
First Name:SABINE
Middle Name:ARWEN
Last Name:KELISCHEK
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 1:70 THE VILLAGE OVERLOOK
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-2742
Mailing Address - Country:US
Mailing Address - Phone:828-631-1960
Mailing Address - Fax:828-586-3489
Practice Address - Street 1:70 THE VILLAGE OVERLOOK
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-2742
Practice Address - Country:US
Practice Address - Phone:828-631-1960
Practice Address - Fax:828-586-3489
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC94-01233207V00000X
SC30572207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAA31647951Medicare PIN
SCAA31647951Medicare PIN
SCAA31643640Medicare PIN