Healthcare Provider Details

I. General information

NPI: 1538118336
Provider Name (Legal Business Name): SARAH H.J. WHITEHEAD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 03/01/2022
Certification Date: 03/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 HIGHLAND AVE
SALEM MA
01970-2714
US

IV. Provider business mailing address

291 MOODY ST
LUDLOW MA
01056-1246
US

V. Phone/Fax

Practice location:
  • Phone: 978-741-1200
  • Fax:
Mailing address:
  • Phone: 413-589-0195
  • Fax: 413-589-7554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number24632
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: