Wallace, Sara Sheehan

Wallace, Sara Sheehan is an individual health care provider with primary practice located at 3240 Sunset Blvd , West Columbia SC 29169-3428. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Wallace, Sara Sheehan can be contacted via phone (803) 359-8855.

Contact Information

Primary practice address
3240 Sunset Blvd West Columbia SC 29169-3428
Phone: (803) 359-8855
Fax: (803) 794-6480
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X LL35809 South Carolina
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 35809 South Carolina

Profile Details

NPI number 1003255605
LBN Legal business name Wallace, Sara Sheehan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 18th, 2013
Last updated Dec 14th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003255605 NPPES
South Carolina MEDICAID 358099
South Carolina Other 35809

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