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General NPI Number Information
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NPI Number | 1023270964
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Entity Type | Individual
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Provider Name | SARAH A MBAEYI
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Gender | Female
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Dates
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Enumeration Date | 07/01/2008
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Last Update Date | 07/22/2019
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Provider Practice Location Address
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Address Line | 1405 CLIFTON ROAD NE CHOA DEPT. OF EMERGENCY MEDICINE
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City | ATLANTA
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State | GA
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Zip | 30322-1062
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Country | US
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Telephone | 404-639-2761
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Fax | 404-679-5071
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Provider Business Mailing Address
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Address Line | 1600 CLIFTON ROAD NE, MS C-25 CHOA DEPT. OF EMERGENCY MEDICINE
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City | ATLANTA
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State | GA
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Zip | 30333
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Country | US
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Telephone | 404-639-2761
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Fax | 404-679-5071
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 065708
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License Number State | GA
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