Provider Demographics
NPI:1659175008
Name:FANGMEYER, SARAH KATHLEEN (DO)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:KATHLEEN
Last Name:FANGMEYER
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12022 LAKE NEWPORT RD
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20194-2742
Mailing Address - Country:US
Mailing Address - Phone:253-549-5905
Mailing Address - Fax:
Practice Address - Street 1:12022 LAKE NEWPORT RD
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20194-2742
Practice Address - Country:US
Practice Address - Phone:253-549-5905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program