Provider Demographics
NPI:1386699742
Name:SAHN, ELEANOR E (MD)
Entity type:Individual
Prefix:DR
First Name:ELEANOR
Middle Name:E
Last Name:SAHN
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 1:900 ISLAND PARK DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:DANIEL ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29492-7559
Mailing Address - Country:US
Mailing Address - Phone:843-856-4465
Mailing Address - Fax:
Practice Address - Street 1:900 ISLAND PARK DR
Practice Address - Street 2:SUITE 104
Practice Address - City:DANIEL ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29492-7560
Practice Address - Country:US
Practice Address - Phone:843-856-4465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11665207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC070016710OtherRR MEDICARE
SC116653Medicaid