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General NPI Number Information
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NPI Number | 1518298223
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Entity Type | Individual
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Provider Name | SARAH MAYFIELD OVERHOLT RD, LDN
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Gender | Female
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Dates
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Enumeration Date | 01/20/2010
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Last Update Date | 01/20/2010
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Provider Practice Location Address
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Address Line | 198 NC HIGHWAY 45 N
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City | PLYMOUTH
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State | NC
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Zip | 27962-9232
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Country | US
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Telephone | 252-791-3111
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 202
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City | PANTEGO
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State | NC
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Zip | 27860-0202
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Country | US
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Telephone | 252-943-6689
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Fax |
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 00982658
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License Number State | NC
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