Healthcare Provider Details

I. General information

NPI: 1508430679
Provider Name (Legal Business Name): SARA KATHERINE MARX CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2021
Last Update Date: 05/13/2021
Certification Date: 05/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 FRONT ST STE 208
BATH ME
04530-2524
US

IV. Provider business mailing address

14 RAYMOND CT
BATH ME
04530-2404
US

V. Phone/Fax

Practice location:
  • Phone: 207-200-7317
  • Fax:
Mailing address:
  • Phone: 443-615-4346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberCPM697
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: