Provider Demographics
NPI:1962002519
Name:ROBERTS, SARA MARGARET (DR)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:MARGARET
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45055 MILLSTONE LN
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20636-2852
Mailing Address - Country:US
Mailing Address - Phone:252-955-2706
Mailing Address - Fax:301-737-0612
Practice Address - Street 1:45055 MILLSTONE LN
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:MD
Practice Address - Zip Code:20636-2852
Practice Address - Country:US
Practice Address - Phone:252-955-2706
Practice Address - Fax:301-737-0612
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-31
Last Update Date:2020-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20430183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist