Provider Demographics
NPI:1215923586
Name:SARBER, LISA JANE (MD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:JANE
Last Name:SARBER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 845
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22404-0845
Mailing Address - Country:US
Mailing Address - Phone:540-891-5544
Mailing Address - Fax:
Practice Address - Street 1:4407 LAFAYETTE BLVD
Practice Address - Street 2:UNIT 4
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-4235
Practice Address - Country:US
Practice Address - Phone:540-891-5544
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101053197207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5874661Medicaid
VA5874661Medicaid