Provider Demographics
NPI:1700271889
Name:SCHLOTTERBECK, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:SCHLOTTERBECK
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 1:395 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-3779
Mailing Address - Country:US
Mailing Address - Phone:413-272-4313
Mailing Address - Fax:
Practice Address - Street 1:395 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-3779
Practice Address - Country:US
Practice Address - Phone:413-272-4313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-05
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA274118207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine