Provider Demographics
NPI:1881693778
Name:EAPEN, SARI GEORGE (MD)
Entity type:Individual
Prefix:
First Name:SARI
Middle Name:GEORGE
Last Name:EAPEN
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 1:257HWY125
Mailing Address - Street 2:ROANOKE VALLEY PAIN CENTER
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-2935
Mailing Address - Country:US
Mailing Address - Phone:252-410-0001
Mailing Address - Fax:252-410-0003
Practice Address - Street 1:257 HWY 125
Practice Address - Street 2:ROANOKE VALLEY PAIN CENTER
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-2935
Practice Address - Country:US
Practice Address - Phone:252-410-0001
Practice Address - Fax:252-410-0003
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26226204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00378382OtherRAILROAD MEDICARE
NC5900284Medicaid
NC5900284Medicaid
NCB08056Medicare UPIN