Healthcare Provider Details

I. General information

NPI: 1467455428
Provider Name (Legal Business Name): CAROLINE A SARTSCHEV MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 10/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 TIMBER DR E
GARNER NC
27529-6926
US

IV. Provider business mailing address

1921 FALLS VALLEY DR
RALEIGH NC
27615-3446
US

V. Phone/Fax

Practice location:
  • Phone: 919-779-6423
  • Fax: 919-662-2021
Mailing address:
  • Phone: 919-872-0250
  • Fax: 919-876-2378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number137570
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0015202390009
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: