Healthcare Provider Details

I. General information

NPI: 1073920336
Provider Name (Legal Business Name): MARIBETH PREWITT SAYRE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2014
Last Update Date: 07/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1335 GALINDO ST
CONCORD CA
94520
US

IV. Provider business mailing address

1335 GALINDO ST
CONCORD CA
94520
US

V. Phone/Fax

Practice location:
  • Phone: 925-687-4451
  • Fax: 925-687-4450
Mailing address:
  • Phone: 925-687-4451
  • Fax: 925-687-4450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberG24026
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: