Healthcare Provider Details

I. General information

NPI: 1992767370
Provider Name (Legal Business Name): SARAH YAVORSKI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 10/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1918 RANDOLPH RD SUITE 670
CHARLOTTE NC
28207-1100
US

IV. Provider business mailing address

PO BOX 60447
CHARLOTTE NC
28260-0447
US

V. Phone/Fax

Practice location:
  • Phone: 704-384-1620
  • Fax: 704-384-1626
Mailing address:
  • Phone: 704-384-1620
  • Fax: 704-384-1626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number9600786
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: