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Individual

SARAH C CAMPBELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1506 S. ONEIDA STREET, PEDIATRICS, APPLETON, WI 54915-1569
(920) 730-4950
Mailing address
1506 S. ONEIDA STREET, PEDIATRICS, APPLETON, WI 54915-1569
(920) 730-4950

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301083413
MI
208000000X
Pediatrics Physician
Primary
45366
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0829560001
MEDICARE DME
MI
01
0C16002
MEDICARE GROUP
05
104654657
MI
05
35388600
WI
01
SC083413
BLUE CROSS STATE ID
MI
Enumeration date
08/14/2006
Last updated
11/30/2011
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