Provider Demographics
NPI:1962760942
Name:BIAS, SARA AMANDA (RD, LD)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:AMANDA
Last Name:BIAS
Suffix:
Gender:F
Credentials:RD, LD
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 9260
Mailing Address - Street 2:8 MEDICAL CENTER DRIVE
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26506-9260
Mailing Address - Country:US
Mailing Address - Phone:888-320-1776
Mailing Address - Fax:617-507-8576
Practice Address - Street 1:8 MEDICAL CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506-9260
Practice Address - Country:US
Practice Address - Phone:888-320-1776
Practice Address - Fax:617-507-8576
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-27
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV863133V00000X
IL164.005071133V00000X
RILDN00896133V00000X
PADN006030133V00000X
NH0846133V00000X
MA4245133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered