Provider Demographics
NPI:1174904379
Name:PEARL, SARAH (DO)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:PEARL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E 104 ST.
Mailing Address - Street 2:MAILSTOP 400S
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-4517
Mailing Address - Country:US
Mailing Address - Phone:816-502-7104
Mailing Address - Fax:816-932-9670
Practice Address - Street 1:2737 NE MCBAINE DR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-7880
Practice Address - Country:US
Practice Address - Phone:816-251-5780
Practice Address - Fax:816-251-5781
Is Sole Proprietor?:No
Enumeration Date:2015-06-12
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-42320207V00000X
MO2019035399207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5315071482OtherPHARMACY LICENSE NUMBER
KS05-42320OtherKANSAS MEDICAL LICENSE
MI5101021937OtherMEDICAL LICENSE NUMBER