Individual
SARAH ELIZABETH PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11082 N RADIO STATION RD, SENECA, SC 29678-1142
(864) 882-2314
(864) 882-3677
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8611
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34805
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
348056
—
SC
01
—
SC6132
MEDICARE
SC
Enumeration date
06/12/2012
Last updated
06/10/2021
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