Provider Demographics
NPI:1861436214
Name:SACCO, SARA ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:ELIZABETH
Last Name:SACCO
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 1:1450 MATTHEWS TOWNSHIP PKWY STE 310
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-2389
Mailing Address - Country:US
Mailing Address - Phone:704-844-6615
Mailing Address - Fax:704-844-6879
Practice Address - Street 1:1450 MATTHEWS TOWNSHIP PKWY STE 310
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-2389
Practice Address - Country:US
Practice Address - Phone:704-844-6615
Practice Address - Fax:704-844-6879
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33740174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
E04297Medicare UPIN
NC#E04297Medicare UPIN