Provider Demographics
NPI:1205426194
Name:GAZAWAY, SARAH E
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:GAZAWAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:474 JO ANN DR SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-7026
Mailing Address - Country:US
Mailing Address - Phone:913-731-3294
Mailing Address - Fax:
Practice Address - Street 1:1360 CENTER DR STE 200
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-4135
Practice Address - Country:US
Practice Address - Phone:678-825-2320
Practice Address - Fax:800-511-2741
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program