Provider Demographics
NPI:1265429906
Name:WINTER, SARAH LYNN (MD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:LYNN
Last Name:WINTER
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 1:50 NORTH MEDICAL DRIVE
Mailing Address - Street 2:DIVISION OF GENERAL PEDIATRICS
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84312
Mailing Address - Country:US
Mailing Address - Phone:801-585-1017
Mailing Address - Fax:801-581-3899
Practice Address - Street 1:50 NORTH MEDICAL DRIVE
Practice Address - Street 2:DIVISION OF GENERAL PEDIATRICS
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84312
Practice Address - Country:US
Practice Address - Phone:801-585-1017
Practice Address - Fax:801-581-3899
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6192401-89052080P0006X
UT6192401-12052080P0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0008XAllopathic & Osteopathic PhysiciansPediatricsNeurodevelopmental Disabilities
No2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2162341Medicaid
KY64028467OtherMEDICAID
OHWI4094021Medicare ID - Type Unspecified
E45662Medicare UPIN