Healthcare Provider Details

I. General information

NPI: 1639582539
Provider Name (Legal Business Name): SARAH ELIZABETH FORSYTHE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH ELIZABETH JOHNSON DO

II. Dates (important events)

Enumeration Date: 06/09/2014
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20209 SENTARA WAY STE 200
CARROLLTON VA
23314
US

IV. Provider business mailing address

20209 SENTARA WAY STE 200
CARROLLTON VA
23314-3574
US

V. Phone/Fax

Practice location:
  • Phone: 757-542-2000
  • Fax:
Mailing address:
  • Phone: 757-542-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO00866
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberLP03136
License Number StateRI
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0102205220
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberCDO00866
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: