Provider Demographics
NPI:1184919805
Name:PRINCE, SARAH ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ELIZABETH
Last Name:PRINCE
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 1:1451 HOSPITAL DR
Mailing Address - Street 2:STE 102
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-8424
Mailing Address - Country:US
Mailing Address - Phone:540-368-5350
Mailing Address - Fax:540-371-3075
Practice Address - Street 1:1451 HOSPITAL DR
Practice Address - Street 2:STE 102
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-8424
Practice Address - Country:US
Practice Address - Phone:540-368-5350
Practice Address - Fax:540-371-3075
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101257004207Q00000X
390200000X
TNMD0000053132207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAFP5657107OtherDEA