Provider Demographics
NPI:1023270964
Name:MBAEYI, SARAH A
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:MBAEYI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:A
Other - Last Name:MEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1600 CLIFTON ROAD NE, MS C-25
Mailing Address - Street 2:CHOA DEPT. OF EMERGENCY MEDICINE
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30333
Mailing Address - Country:US
Mailing Address - Phone:404-639-2761
Mailing Address - Fax:404-679-5071
Practice Address - Street 1:1405 CLIFTON ROAD NE
Practice Address - Street 2:CHOA DEPT. OF EMERGENCY MEDICINE
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1062
Practice Address - Country:US
Practice Address - Phone:404-639-2761
Practice Address - Fax:404-679-5071
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA065708208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics