Healthcare Provider Details

I. General information

NPI: 1477642908
Provider Name (Legal Business Name): SARAH ANN HILL WELLS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 08/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 OLD CHEROKEE RD MEDMISSION AT MT. HOREB UMC
LEXINGTON SC
29072
US

IV. Provider business mailing address

PO BOX 1661
LEXINGTON SC
29071-1661
US

V. Phone/Fax

Practice location:
  • Phone: 803-931-2168
  • Fax:
Mailing address:
  • Phone: 803-931-2168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number29180
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: