Healthcare Provider Details

I. General information

NPI: 1073191839
Provider Name (Legal Business Name): SARAH MANSAGER DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 MEDICAL PARK STE 202
WHEELING WV
26003-6392
US

IV. Provider business mailing address

40 MEDICAL PARK STE 202
WHEELING WV
26003-6392
US

V. Phone/Fax

Practice location:
  • Phone: 304-243-8396
  • Fax:
Mailing address:
  • Phone: 304-243-8396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number10535
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: