Healthcare Provider Details

I. General information

NPI: 1578881983
Provider Name (Legal Business Name): SARAH ANN KORTH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2010
Last Update Date: 06/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N BROADWAY
BALTIMORE MD
21205
US

IV. Provider business mailing address

707 N BROADWAY
BALTIMORE MD
21205-1888
US

V. Phone/Fax

Practice location:
  • Phone: 443-923-9440
  • Fax: 443-923-9445
Mailing address:
  • Phone: 443-923-9440
  • Fax: 443-923-9445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD80175
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberD80175
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: