Healthcare Provider Details

I. General information

NPI: 1225329899
Provider Name (Legal Business Name): SARAH ANNE HUBER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SALLY HUBER M.D.

II. Dates (important events)

Enumeration Date: 04/29/2011
Last Update Date: 07/21/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1357 OCONEE CONNECTOR
WATKINSVILLE GA
30677
US

IV. Provider business mailing address

1561 JANMAR RD
SNELLVILLE GA
30078-5639
US

V. Phone/Fax

Practice location:
  • Phone: 678-344-8900
  • Fax:
Mailing address:
  • Phone: 678-344-8900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number289516-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25MA09907000
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD-42685
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number75107
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number075107
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: