Provider Demographics
NPI:1740379023
Name:MERRILL, SARAH ANNE (MD)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ANNE
Last Name:MERRILL
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 1:19441 GOLF VISTA PLAZA
Mailing Address - Street 2:SUITE 320
Mailing Address - City:LANSDOWNE
Mailing Address - State:VA
Mailing Address - Zip Code:20176
Mailing Address - Country:US
Mailing Address - Phone:703-858-9800
Mailing Address - Fax:703-858-9801
Practice Address - Street 1:19441 GOLF VISTA PLAZA
Practice Address - Street 2:SUITE 320
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176
Practice Address - Country:US
Practice Address - Phone:703-858-9800
Practice Address - Fax:703-858-9801
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101102520207W00000X
MDD0061944207W00000X
DCMD034340207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA014572M51Medicare PIN
I10702Medicare UPIN