Healthcare Provider Details

I. General information

NPI: 1609850114
Provider Name (Legal Business Name): SARA LYNN NEAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 09/30/2021
Certification Date: 09/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 N CHURCH ST
GREENSBORO NC
27401-1007
US

IV. Provider business mailing address

1125 N CHURCH ST
GREENSBORO NC
27401-1007
US

V. Phone/Fax

Practice location:
  • Phone: 336-832-8035
  • Fax: 336-832-8094
Mailing address:
  • Phone: 336-832-8035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number9600385
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9600385
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: