Provider Demographics
NPI:1548294911
Name:CORATHERS, SARAH DAWN (MD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:DAWN
Last Name:CORATHERS
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 1:3333 BURNET AVE.
Mailing Address - Street 2:MLC 7012
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229
Mailing Address - Country:US
Mailing Address - Phone:513-636-4744
Mailing Address - Fax:513-636-7486
Practice Address - Street 1:3333 BURNET AVE.
Practice Address - Street 2:MLC 7012
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229
Practice Address - Country:US
Practice Address - Phone:513-636-4744
Practice Address - Fax:513-636-7486
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0886452080P0205X, 2080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200843610Medicaid
OH2692288Medicaid
KY64131329Medicaid
WV3810009325Medicaid
KY64131329Medicaid