MEDICARE: DR. SARAH E RELYEA-LOGAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	39035	SC
2	207Q00000X	Family Medicine Physician	0101-236413	VA

General Provider Information

NPI Number	:	1043292576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH E RELYEA-LOGAN MD

Provider Business Mailing Address
First Line	:	21 GEORGE ST STE 100
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29401-1489
Country	:	US
Telephone Number	:	843-779-8570
Fax Number	:

Provider Business Practice Location Address
First Line	:	345 FRESHFIELDS DR STE J101
Second Line	:
City	:	JOHNS ISLAND
State	:	SC
Zip	:	29455-5443
Country	:	US
Telephone Number	:	843-768-4800
Fax Number	:	843-606-8039

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	03/26/2026

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