Healthcare Provider Details

I. General information

NPI: 1952417511
Provider Name (Legal Business Name): SARA HELEN GOLDSBERRY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 09/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 NORTH SECOND STREET
RIPLEY OH
45167-1101
US

IV. Provider business mailing address

5400 DUPONT CIRCLE SUITE A
MILFORD OH
45150-2770
US

V. Phone/Fax

Practice location:
  • Phone: 937-392-4381
  • Fax: 937-392-4383
Mailing address:
  • Phone: 513-576-7700
  • Fax: 513-576-1020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35076420
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: