Provider Demographics
NPI:1336239508
Name:PETERS, SARA B (MD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:B
Last Name:PETERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:430 ALTAIR PKWY
Mailing Address - Street 2:STE 210
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-7647
Mailing Address - Country:US
Mailing Address - Phone:614-898-7546
Mailing Address - Fax:614-794-4294
Practice Address - Street 1:430 ALTAIR PKWY
Practice Address - Street 2:STE 210
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-7647
Practice Address - Country:US
Practice Address - Phone:614-898-7546
Practice Address - Fax:614-794-4294
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35088779207ZD0900X, 207ZP0101X, 207ZC0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0006XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2692877Medicaid