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NPI Code Detail

MEDICARE: SARA DANIELLE GREENBAUM PA-C

MEDICARE: SARA DANIELLE GREENBAUM PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1568318418
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA DANIELLE GREENBAUM PA-C
Provider Business Mailing Address
First Line : PO BOX 40908
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28309-0908
Country : US
Telephone Number : 910-615-6949
Fax Number :
Provider Business Practice Location Address
First Line : 1638 OWEN DR
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-3424
Country : US
Telephone Number : 910-615-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2026
Last Update Date : 06/10/2026

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