Healthcare Provider Details

I. General information

NPI: 1306362884
Provider Name (Legal Business Name): SARA ALICIA GUASCH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2017
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARILION ROANOKE MEMORIAL HOSPITAL 1906 BELLEVIEW AVE
ROANOKE VA
24014
US

IV. Provider business mailing address

CARILION ROANOKE MEMORIAL HOSPITAL 1906 BELLEVIEW AVE
ROANOKE VA
24014
US

V. Phone/Fax

Practice location:
  • Phone: 540-981-7000
  • Fax:
Mailing address:
  • Phone: 540-981-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2024-03420
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: