Provider Demographics
NPI:1982771986
Name:JAMIESON, SARAH CLAY (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:CLAY
Last Name:JAMIESON
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 1:300 RIGGS AVE
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-4424
Mailing Address - Country:US
Mailing Address - Phone:410-858-0395
Mailing Address - Fax:
Practice Address - Street 1:2001 MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3280
Practice Address - Country:US
Practice Address - Phone:443-481-5187
Practice Address - Fax:443-481-5199
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0058495208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD510411400Medicaid
MD510411400Medicaid
MD939RMedicare ID - Type Unspecified